Follow up after breast cancer treatment

After treatment for breast cancer, you usually have regular check ups at the hospital. This is to check how you are and see whether you have any problems or concerns. Over time, these appointments become less frequent. 

Why you might have follow up appointments

At each follow up your doctor or nurse checks how you are coping with any ongoing treatment for example, hormone therapy.

Your healthcare team can give you information and support to help you cope. Your appointments are also a good opportunity to raise any concerns and ask questions that you might have.

How often are my check ups?

How often you have check ups depends on a number of factors. These include:

• how you are feeling
• the type of treatment you have had 
• whether you are still having treatment such as hormone therapy
• on your hospital or clinic

Ask your doctor or specialist nurse how often your follow up appointments are likely to be. You may have regular check ups for at least 5 years. 

Supported self management or patient initiated follow up (PIFU)

Some hospitals have a system of follow ups where you don't have regular appointments. In this system, you might have regular phone calls with your breast specialist nurse. You can also contact them and arrange an appointment if you have any new symptoms or are worried about anything. 

You are usually discharged from the follow up after 5 years. This means that your GP will take over your care. 

What happens?

Your doctor or nurse specialist ask how you are feeling and whether you have had any symptoms or side effects. Tell them if you are worried about anything.

If you are seen at the hospital, your doctor or nurse might examine you. You might also see physiotherapists and dietitians during the check ups. You can arrange to see them with your doctor or nurse at the outpatient clinic.

The National Institute for Health and Care Excellence (NICE) guidelines say that everyone who has had treatment for breast cancer should have a copy of a written care plan.

The care plan has information about:

• the tests you need such as mammograms
• signs and symptoms to look out for and who to speak to if you notice any changes
• contact details for specialist staff, such as your breast care nurse
• details of support services who can help with problems such as arm swelling (lymphoedema)
• information about treatment you may be taking, for example hormone therapy

What tests will I have?

You usually have a mammogram every year, for at least 5 years, after treatment for breast cancer. 

Women under 50 years
You have mammograms every year until you are invited for routine breast screening. This is around the age of 50.

Women over 50 years
You have mammograms every year for 5 years. After 5 years, you have a mammogram every 3 years as part of the National Screening Programme.

Mammograms after having a mastectomy 
You have a mammogram of the opposite breast if you’ve had a mastectomy . This means that if you had a mastectomy of the right breast, you only have a mammogram of the left breast.

NHS Breast Screening Programme
The NHS Breast Screening Programme invites all women from the age of 50 to 70 for screening every 3 years. After the age of 70, you can arrange your own regular mammograms by contacting your local screening service.

You are not routinely offered other tests to follow up breast cancer unless you have symptoms or are feeling unwell. 

Some women may have a bone density scan to check their bone strength. You might have this if you are taking a type of hormone therapy called an aromatase inhibitor. 

Between appointments

How you might feel?

Coming to the end of treatment is a milestone for many. But you can have mixed feelings about this, particularly as you’ve had regular contact with your healthcare team and it’s now less frequent.

Some people also find their check ups quite worrying. A hospital appointment can bring back any anxiety you had about your cancer.

It can help to tell someone close to you how you’re feeling. Sharing your worries can mean they don’t seem so overwhelming. Many people find it helpful to have counselling during or after cancer treatment.

You can also find people to share experiences with by using our online forum, Cancer Chat.

Life after cancer

In this video Yvonne shares her story of life after breast cancer and how she coped when her treatment finished. She talks about some of the physical effects of the cancer and its treatment and what helped her through.

She and her sister Sonia also talk about what it was like going to check up appointments, something that is not always easy. Coping after treatment finishes can be challenging and hearing about how other people cope can help.