Essential Follow-Up Tests for Breast Cancer Survivors: What You Need to Know

Breast Cancer Follow-Up Content

Hello, doctor.
I was diagnosed with breast cancer last year and underwent surgery and chemotherapy, with a diagnosis of stage II.
I would like to know what follow-up examinations are necessary.
I ask this because my attending physician provided me with a recommendation from the American Cancer Society stating that I only need to have imaging done once a year, physical examinations every 3-6 months, and self-examinations monthly.
As for blood tests, he mentioned that long-term studies abroad have shown they are unnecessary.
He also suggested that we pay out of pocket for the Songhua genetic testing.
To be honest, I am somewhat dissatisfied with his recommendations because they seem to encourage us to opt for out-of-pocket tests while excluding those that are generally more reassuring.
What are the current recommendations for follow-up examinations for breast cancer patients in Taiwan?

Xi Xi, 30~39 year old female. Ask Date: 2005/04/14

Dr. Wu Jingtang reply Breast and Thyroid

Dear Miss Xixi,
Your question is a bit difficult to answer.
Basically, your physician is correct; there is research that supports the recommendations made by the American Cancer Society.
However, some have found that recurrence or metastasis can be detected through regular blood tests, which is why blood monitoring has also been accepted.
I believe this is because even when metastasis is detected, the treatment or prognosis between the two groups of patients (those who undergo blood tests and those who do not) showed no significant differences in that study.

My recommendation is to have blood tests, chest X-rays, and bone scans at least once a year to allow for comparison, hoping that any issues will not be discovered too late.
As for participating in the Songhua genetic testing at your own expense, to be honest, I am less familiar with that aspect.
You may want to consult your physician about what specific actions can be taken after the genetic testing and what information can be obtained before making a decision.
Wishing you good health,
Dr.
Wu

Reply Date: 2005/04/14

More Info

As a breast cancer survivor, it is essential to understand the follow-up care and monitoring required after treatment. Your concern about the adequacy of the follow-up plan provided by your physician is valid, and it's crucial to have a clear understanding of what is recommended based on current medical guidelines and research.

Recommended Follow-Up Care for Breast Cancer Survivors
1. Regular Physical Examinations: After completing treatment, it is generally recommended that breast cancer survivors have a physical examination every 3 to 6 months for the first few years, followed by annual check-ups. During these visits, your healthcare provider will assess for any signs of recurrence or new cancers.

2. Imaging Tests: Mammograms are typically recommended annually for breast cancer survivors. The American Cancer Society suggests that survivors should continue to have regular mammograms as part of their follow-up care. Depending on your specific situation, additional imaging tests such as breast ultrasounds or MRIs may be warranted, especially if you have dense breast tissue or other risk factors.

3. Self-Examinations: Monthly self-breast examinations are encouraged to help you become familiar with your breasts and to notice any changes. While the effectiveness of self-exams in reducing mortality is debated, they can help you feel more in control of your health.

4. Blood Tests: Routine blood tests, including tumor markers, are not universally recommended for breast cancer survivors unless there are specific symptoms or concerns. Research has shown that these tests do not significantly improve outcomes in asymptomatic patients. However, your doctor may recommend certain blood tests based on your individual health status and treatment history.

5. Genetic Testing: If you have a family history of breast cancer or other risk factors, genetic testing may be suggested. This can help assess your risk for recurrence or for developing other cancers. If your physician has suggested participating in genetic testing, it may be worth discussing the potential benefits and implications with them.

6. Lifestyle Modifications: Maintaining a healthy lifestyle is crucial for breast cancer survivors. This includes a balanced diet, regular physical activity, and avoiding tobacco and excessive alcohol consumption. These factors can significantly impact your overall health and may reduce the risk of recurrence.

7. Mental Health Support: The emotional and psychological impact of breast cancer treatment can be significant. Consider seeking support from counseling, support groups, or mental health professionals to help cope with any anxiety or depression that may arise post-treatment.

Addressing Your Concerns
It is understandable to feel dissatisfied with the follow-up plan suggested by your physician, especially if it seems to lack comprehensive testing. It is essential to communicate your concerns openly with your healthcare provider. You might consider asking the following questions:
- What is the rationale behind the recommended follow-up schedule?
- Are there specific signs or symptoms I should be vigilant about?
- Can we discuss the potential benefits of additional tests, such as blood tests or imaging, based on my individual risk factors?
- How can I best monitor my health and well-being during this period?
If you still feel uncertain about the follow-up plan, seeking a second opinion from another oncologist or breast cancer specialist may provide additional insights and reassurance.

Conclusion
In summary, follow-up care for breast cancer survivors typically includes regular physical exams, annual mammograms, self-examinations, and lifestyle modifications. While blood tests and genetic testing may be beneficial in certain situations, they are not universally required. It is crucial to have an open dialogue with your healthcare provider to ensure that your follow-up care aligns with your needs and concerns. Remember, you are your best advocate in your health journey, and it is essential to feel confident and informed about your care plan.

Similar Q&A

Post-Surgery Follow-Up for Endometrial Cancer: Essential Tests and Guidelines

Hello, Director Cao. In March of this year, I underwent a hysterectomy and oophorectomy due to stage I endometrial cancer. My attending physician advised that I should have a chest X-ray and blood tests every three months, and a CT scan for follow-up once a year. However, when I ...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, each physician may have a different approach. Generally, tests such as blood tests for cancer markers, chest X-rays, CT scans, and Pap smears can be performed, but the choice varies among physicians. As for estrogen, it is advisable to use it sparingly if possible. Wishing...

Post-Mastectomy Reconstruction: Essential Follow-Up Care and Checks

Hello, doctor. I underwent a total mastectomy on my left breast due to a larger phyllodes tumor, and an immediate reconstruction with a prosthesis was performed. The post-operative report indicates that the tumor falls into the gray zone category. What should I pay attention to a...

Dr. Yuan Tianmin reply Breast and Thyroid
Post-operative examinations for breast prostheses can only be performed using ultrasound, as mammography cannot be used on the affected side.

Is Genetic Testing Necessary for Stage 1 Breast Cancer Patients?

Hello Doctor: I have questions regarding the follow-up treatment for breast cancer. The pathology report shows Ki-67: 5%, ER: positive 95%, PR: positive 95%, HER-2: negative. I have undergone a partial mastectomy and sentinel lymph node biopsy on the right breast. CT scans, bone ...

Dr. Chen Yunfang reply Oncology
Hello: The standard treatment for breast cancer is fully covered by health insurance. For T1CN0M0 stage I, after surgery, six cycles of FEC (a second-generation chemotherapy regimen) are administered, which is free of charge. Following that, radiation therapy and hormonal therapy...

Post-Chemotherapy Management for Breast Cancer Patients: Key Considerations

The patient has right breast cancer and has undergone a total mastectomy and axillary lymph node dissection. The pathology report indicates the following: Stage: IIB, Tumor size: 2.4 cm, Lymph nodes: positive for metastasis (2, 11), Distant metastasis: none, Tumor type: IDC ER: 9...

Dr. Chen Sirong reply Oncology
Patient: 46 years old, male 1. I would like to ask, what are the key reasons for the consultation with the radiologist to assess whether additional radiation therapy and oral chemotherapy are necessary? A: If the lymph nodes have not metastasized, and the tumor is less than 4 c...