1. What is follow-up?
Once hospital treatment for breast cancer ends, you’ll continued to be monitored. This is known as follow-up.
Different people are followed up in different ways. How you’re followed up after treatment will depend on factors such as:
- How likely you are to have side effects from treatment
- The risk of your cancer coming back
- Arrangements at the hospital where you’ve been treated
2. How will I be followed up?
You’ll usually be offered a regular , depending on the type of surgery you’ve had.
You may or may not also have regular appointments.
Follow-up without regular appointments
You may not be offered any regular follow-up clinic appointments after treatment ends.
Instead, before being discharged from the breast clinic, you’ll be given information to help you manage your health after treatment.
After this you can see your GP or access the breast clinic if you have concerns or symptoms that need to be checked by a doctor or nurse.
If you’re offered this sort of follow-up plan, you should be given details of:
- Who to contact
- How best to do this
- The types of concerns or symptoms to report
Follow-up with regular appointments
You may be offered planned appointments with members of your healthcare team. How often this happens varies.
Many people are followed up at the hospital and have regular appointments with their surgeon or . Some people may also be followed up by their GP or have a combination of hospital and GP appointments.
In some hospitals follow-up is provided by the breast care nurse unless there are particular concerns.
Sometimes follow-up appointments take place by phone or email, and you’ll only visit the breast clinic for a mammogram or if there’s a concern or symptom that you or your doctor feel should be checked.
What happens at follow-up appointments?
Follow-up appointments usually focus on how you’re feeling. You can explain any problems, symptoms or treatment side effects you have. This is also your opportunity to ask questions. Writing your questions down beforehand can help you get the most out of the appointment.
If you attend in person you may have a physical examination that includes your breast or chest area as well as any other area of concern.
If you have any concerns you may be referred to another healthcare professional, for example a physiotherapist if you’re having problems with arm movement or a pain clinic if you’re experiencing persistent pain.
Follow-up after clinical trials
If you have taken part in a clinical trial during your treatment, your follow-up may vary depending on which trial you have been part of.
Your research nurse will give you information on how you’ll be followed up.
3. The Recovery Package
This is a package of ongoing care and support at the end of treatment.
It might not be offered in all areas or may be called something else.
You may hear your treatment team talk about the Recovery Package or about parts of the package separately.
If you’re not offered any parts of the Recovery Package you can ask your healthcare team for more information.
The Recovery Package is made up of four main parts.
Holistic needs assessment and care planning
A holistic needs assessment (HNA) helps you think about your needs and concerns across all areas of your life and find possible solutions.
It will consider your physical, social, psychological and spiritual needs.
You may be offered an HNA at various times throughout your diagnosis and treatment and at the end of treatment. After each assessment you’ll be given a copy of a written care or action plan.
Treatment summary
This is a summary produced by your hospital team at the end of treatment and sent to your GP.
It includes information about:
- Treatment side effects
- Signs and symptoms of a possible recurrence
- Symptoms that should be referred to your treatment team
- Any action that needs to be taken by the GP
You may also receive a copy of the treatment summary.
A GP review
This is a meeting with your GP, within 6 months of diagnosis, to review any concerns you have and to help you understand what information and support is available in your local area.
If you haven’t been offered a review and would like one, contact your GP.
Health and wellbeing support event
This could include an appointment at a health and wellbeing clinic, which provides advice on healthy living and physical activity or an invitation to a group event or workshop.
Our Moving Forward courses offer information and support on adjusting to life after treatment.
4. Mammograms after breast cancer
You’ll be invited to have regular mammograms after your treatment.
You’ll be offered:
- Mammograms on both breasts if you had breast-conserving surgery
- A mammogram on your unaffected breast if you had a (with or without reconstruction)
You will not be offered any mammograms if you had a double mastectomy.
How often will I have mammograms?
Most hospitals follow the recommendations below from the National Institute for Health and Care Excellence (NICE).
If you’re under 50
If you’re under 50, you’ll have a yearly mammogram until you’re invited to take part in a national breast screening programme, usually around the age of 50 (please see below).
If you’re eligible for screening
If you were already eligible for breast screening when diagnosed, you’ll have a yearly mammogram for 5 years. After this, you’ll be offered routine screening.
All women aged 50 to 70 are invited for mammograms every 3 years as part of a national breast screening programme. After the age of 70 you can still have regular mammograms but you’ll need to arrange this yourself by contacting the screening unit covering your area.
In some areas in England, women are invited before the age of 50 and after 70 as part of a trial.
If you have a family history or altered gene
Women who remain at high risk because of a family history of breast cancer or who carry an altered BRCA gene will be offered regular tests for a longer period.
5. Will I have other tests and scans?
You won’t usually have other routine scans and tests unless you have symptoms that need checking.
Several large studies have shown having regular scans when there are no symptoms is not useful in finding recurrence and doesn’t improve overall survival.
Some people may be offered scans to check their bone strength. This is because some treatments for breast cancer, such as hormone therapy and chemotherapy, can affect the bones and increase the risk of developing .
6. Further support
For some people, the last hospital-based treatment is the goal they focus on, and getting there can feel like a real achievement. But some people also feel isolated, low or anxious when their regular hospital appointments stop.
You may be experiencing ongoing side effects of treatment, thinking about going back to work or worrying about the cancer coming back. You might feel under pressure to get back to ‘normal’, but find it difficult to adapt to life after treatment.
Sign up to our Moving Forward courses - please see below - where you can meet others who have finished treatment, and get tips from professionals.
And speak to people who understand what you’re going through by joining a Moving Forward thread on our Forum, or by calling our helpline number below.
