Follow-Up Care for Breast Cancer Patients

After patients have completed treatment for early stage breast cancer, one of the common questions is "How should I best be monitored?" At the current time, the standard approach for monitoring patients is for them to be seen for a physical exam and a review of symptoms anywhere from every 3-6 months for the first 2-3 years, then every 6 months until year 5, and annually thereafter. You should also continue to have annual mammograms of the other breast. In some cases following a lumpectomy, we may recommend a mammogram of the involved breast every 6 months for 2-3 years and then yearly thereafter. We also ask you to report any new or unusual symptoms so that we can determine whether any further testing needs to be done.

In terms of screening for the spread of breast cancer (metastases), the routine use of chest x-rays and blood tests for patients who have no symptoms is generally not recommended. The reason for this is that even though these tests may pick up a recurrence at an earlier moment, it is not clear that the earlier institution of therapy for advanced breast cancer will ultimately lead to a better long term result. This is because when patients have metastatic recurrence, the focus of therapy is to keep the cancer under control but our ability to cure cancer is limited. Furthermore, screening tests such as x-rays and blood tests can also appear abnormal when in fact there is no spread of cancer and it may require more invasive testing, such as a biopsy, to sort this out. For these reasons, most expert panels have concluded that at the current time, these types of screening tests for spread of cancer are not warranted.

Please refer to the ASCO Guidelines for a more detailed explanation of the latest recommendations for following patients after treatment for early stage breast cancer.