Follow-up after breast cancer

Follow-up is recommended after treatment for breast cancer to check whether breast cancer has come back, to monitor side effects of treatment and to provide practical and emotional support.

Women who have been diagnosed and treated for early breast cancer have an increased risk of breast cancer coming back or developing in the other breast. Regular follow-up means that if breast cancer does come back or if a new breast cancer develops, it can be treated promptly. Follow-up also allows doctors to check for any side effects from treatment and to monitor any long-term treatments such as hormonal therapies. It also provides an opportunity for women to talk about how they’re feeling.

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What does follow-up involve?

Follow-up after treatment for breast cancer involves regular physical examinations and breast imaging tests (mammogram and/or ultrasound).

Appropriate follow-up does not involve chest X-rays, bone scans or blood tests unless the woman has symptoms which suggest that cancer has spread outside the breast or armpit area.

Some women assume that they should be having regular scans and blood tests. However, studies have shown that having more tests does not improve the length or quality of life for women who have been treated for breast cancer.

A woman’s follow-up schedule will be planned based on her individual circumstances. Women who are involved in a clinical trial may have some tests in addition to those listed here.

Women who are receiving a hormonal therapy, such as tamoxifen or an aromatase inhibitor, will have follow-up tests while taking these therapies.

Some women find it reassuring to have regular follow-up tests. Others feel anxious around the time of their appointments. Both reactions are normal.

What happens if a breast change is found at follow-up?

For most women, no changes are found during follow-up appointments. However, if breast imaging tests show an abnormal area, or if the doctor finds a lump during a physical examination, the woman will need to have further tests. This may include more imaging tests and a biopsy.

If you notice a breast change or any other symptoms that concern you between follow-up appointments, don’t wait until your next appointment. See your GP or specialist as soon as possible.

Physical examinations

The doctor will ask about any symptoms since the last visit and will do a physical examination of both breasts (or the chest area if the woman has had a mastectomy), the arm and other parts of the body if relevant.

The frequency of these tests will depend on a woman’s individual situation and how long it is since she finished treatment.

In general, the recommended timing for physical examination/history is:

years 1–2 after treatment: every 3–6 months
years 3–5 after treatment: every 6–12 months
more than 5 years after treatment: every year.

Physical examinations could be more or less often than this.

Breast imaging tests

A mammogram and/or ultrasound will be done to look for changes in the breasts. These tests will usually be done before the follow-up appointment so that the results can be discussed with the doctor.

In general, it’s recommended that women have a mammogram once a year, with the first mammogram 1 year after diagnosis.

After a diagnosis of breast cancer women may no longer be able to have mammograms at BreastScreen (this varies by state and territory). Women who are no longer able to have mammograms at BreastScreen will be given a referral to a radiology clinic for follow-up mammograms and/or ultrasounds.