Follow Up

Even if you have completed breast cancer treatment, your doctors will want to watch you closely. It’s very important to go to all of your follow-up appointments. During these visits, your doctors will ask if you are having any problems, and will probably examine you. Lab tests and imaging tests aren’t typically needed after treatment for most early stage breast cancers, but they might be done in some women to look for signs of cancer or treatment side effects.

Almost any cancer treatment can have side effects. Some might only last for a few days or weeks, but others might last a long time. Some side effects might not even show up until years after you have finished treatment. Visits with your doctor are a good time for you to ask questions and talk about any changes or problems you notice or concerns you have. However, if you have additional concerns about your cancer, you do not have to wait until your next scheduled visit. You can call your doctor immediately.

If you have finished treatment, your follow-up doctor visits will probably be scheduled for every few months at first. If you had breast-conserving surgery (lumpectomy or partial mastectomy), you will likely get a mammogram about 6-12 months after surgery and radiation are completed, and then at least every year after that. If you are taking either of the hormone drugs tamoxifen or toremifene and still have your uterus, you should have pelvic exams every year because these drugs can increase your risk of uterine cancer. f you are taking a hormone drug called an aromatase inhibitor (anastrozole, letrozole, or exemestane) for early stage breast cancer, or if you go through menopause as a result of treatment, your doctor will want to monitor your bone health and may consider testing your bone density. If symptoms, exams, or tests suggest a possible recurrence of your cancer, imaging tests such as an x-ray, CT scan, PET scan, MRI scan, bone scan, and/or a biopsy may be done.

Lymphedema can be prevented or controlled usually. Infection can increase the risk of lymphedema. In case of any abnormal change in your arm you have to let your doctor know.

Ongoing Risk of Relapse in Patients Who Have Completed 5 Years of Treatment

Current treatment approaches in early stage breast cancer have increased survival and reduced recurrence.

In 2003, preliminary results of a study investigating the effect of Aromatase Inhibitors (AI) were published. Accordingly, AI significantly reduced the risk of recurrence in women who had completed standard adjuvant therapy. More than 5000 women with HR+ who had completed standard adjuvant antiestrogen therapy were randomized to either AI or placebo within 3 months of treatment discontinuation. According to the evaluation findings at the end of the 30-month follow-up period, AI provided a 42% reduction in the relative risk of recurrence. AI also reduced the risk of distant spread and significantly improved overall survival in patients with lymph node involvement.

In conclusion, AI provided a significant improvement in disease-free survival in the group that completed 5 years of standard adjuvant antiestrogen therapy, local recurrence, a significant reduction in contralateral events, and a significant improvement in overall survival in the node-positive group. The overall survival advantage in AI adjuvant practice has been proven. According to the results from clinical studies, although the ASCO treatment guidelines recommend extending AI therapy up to 2.5 years in patients who complete standard adjuvant therapy, one study concluded that after 5 years of antiestrogen therapy, prolonged AI therapy for up to 4 years in disease-free postmenopausal women is safe and clinically effective. is indicated. Studies investigating the effects of prolonging treatment with AI for up to 10 years in preventing recurrence risk are still ongoing. Judging by the data from all these close clinical studies, the American Cancer Society and St. Gallen International Consensus Panel recommends the use of AI in extended adjuvant therapy.