After you finish your treatment for breast cancer, you will have regular follow-up visits to the Westmead Breast Cancer Institute (BCI).
At first, these visits will be frequent, and as time goes by, they will become less frequent. For most women, follow-up is for 5 years, and is carried out by the Westmead BCI team.
After this time you will continue to have annual breast cancer checks (including mammograms if needed) with your general practitioner (GP) and return to the Westmead BCI if any problems develop.
When you attend the clinic, you will be seen by one of the members of the Westmead BCI multidisciplinary team. This may be 1 of your specialists (your surgeon, radiation oncologist, medical oncologist or breast physician), one of the other doctors in the team, or a specialist breast care nurse.
Often visits will alternate between different specialists within the multidisciplinary team. The different team members are in constant contact with each other, and if any issues come up you will quickly be seen by the most appropriate person.
The timing of your follow-up appointments will vary depending on your circumstances. The type of cancer and the treatment you had will be considered, and an individual plan will be developed for you. In general, you will be seen every 3 to 6 months for the first 2 years, then every 6 to 12 months.
Women who have participated in clinical trials may be on a different follow-up schedule. Your team will let you know what your schedule will be.
The doctor or nurse looking after you will talk to you about any symptoms that may be worrying you. They will also talk to you about treatment you may still be having (such as tamoxifen or aromatase inhibitor tablets) and discuss the treatment plan and any side effects you may be experiencing.
You will have a clinical breast examination at each follow-up visit. Almost all women will have a mammogram (and sometimes an ultrasound as well) once a year. These are usually arranged to occur before a visit so that the results are available at the consultation. Your doctor may recommend that your mammogram be done at the Westmead Breast Cancer Institute or may refer you to a local radiology practice.
If you are well 5 years after your breast cancer treatment you are also eligible to have a free mammogram each year through the BreastScreen program.
Mammograms are not needed for the treated side of your chest if you had a mastectomy.If you are taking an aromatase inhibitor tablet such as Arimidex (anastrozole), Femara (letrozole) and Aromasin (exemestane), it may be recommended that you have a bone density test every 1 to 2 years, to make sure the tablets are not affecting your bones. A blood test to measure your vitamin D level may also be recommended. If there is a decrease in your bone density you may be referred to an endocrinologist to discuss treatment.
One of the other important aims of follow-up care is to keep you as healthy as possible, so your doctor or nurse may also talk to you about lifestyle issues (For example, diet, physical activity and general health care). Apart from breast imaging once a year, there are no routine scans or blood tests that are recommended to monitor cancer. This is because there is good research to show that more tests are not useful in finding further cancer spread, and they don’t improve overall survival.
It is recommended that as well as attending your follow-up visits, you check your breasts regularly (every 1 to 2 months) and report any changes you may notice. If you find lumps or skin changes in the breast, chest wall, armpit or collarbone area, speak to one of the doctors or nurses at the Westmead BCI or see your general practitioner.
Keeping yourself as healthy as possible and paying attention to your general health and fitness is essential. There is increasing research to show that getting plenty of physical activity, eating a balanced diet, minimising alcohol intake and keeping your weight within a healthy range all reduce the risk of your breast cancer returning.
Many women feel anxious about coming back for their follow-up visits. This is a very normal reaction. It can be helpful to think of it as a time when any concerns or problems you have can be discussed. The doctors and nurses are all experienced and they understand that this can be a worrying time.
If you find yourself worrying about cancer at other times, mention it to one of the health professionals. There are people who can help you manage this.
| Organisation | Contact |
|---|---|
| Westmead Breast Cancer Institute | (02) 8890 6728 |
| Cancer Council Helpline | 13 11 20 |
| Breast Cancer Network Australia | 1800 500 258 |
| Cancer Australia |
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