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Breast cancer is highly treatable, and many people live for years or decades after completing their therapy. But once you get through breast cancer treatment — which can change your life and affect your family, too — what’s next?
Read on to learn what to expect five and 10 years after breast cancer treatment, as well as how to manage later side effects of treatment.
According to the American Cancer Society, women diagnosed with breast cancer are about 90 percent as likely as those without cancer to live at least five years. Your doctor will follow your recovery from treatment closely and check for signs that your cancer could be returning.
For the first five years after treatment, your doctors will watch you closely. Your follow-up schedule will depend on the type and stage of your cancer and may look different from someone else’s plan.
Usually, doctors will recommend getting a physical examination every three to six months for the first three years. This may be extended to every six to 12 months for the next two years. Five years after breast cancer treatment, most people will have a physical exam once a year.
After one year, people with early-stage breast cancer who have a tumor measuring less than 5 centimeters and fewer than four lymph nodes involved, may be able to transfer their follow-up care to their primary care provider from their oncologist, if they wish.
In addition to offering age-appropriate preventive care, your doctor may recommend some tests based on your health history and the type of treatment you received.
If you had breast-conserving surgery, getting a mammogram every six to 12 months will likely be recommended. Breast-conserving surgery, also known as a lumpectomy or partial mastectomy, leaves healthy breast tissue while removing cancer cells. Because breast tissue remains, a mammogram is still necessary for the treated breast as well as the untreated breast.
If you had a single mastectomy, you may need a mammogram of your remaining breast.
Your health care provider will likely recommend that you have a pelvic exam every year to screen for uterine (endometrial) cancer. Some medications, such as the hormonal therapies tamoxifen (Soltamox) and toremifene (Fareston), can increase the risk of uterine cancer in people who still have a uterus. The risk is especially high in those who have gone through menopause.
Some breast cancer treatments, such as those that block estrogen or cause early menopause, can weaken your bones and increase your risk of osteoporosis and fractures. Estrogen helps slow the natural breakdown of bone, so reducing the body’s amount of this hormone can trigger bone loss.
If you are taking an aromatase inhibitor for early-stage breast cancer treatment, your doctor will want to monitor your bone density. A dual-energy X-ray absorptiometry (DEXA) scan is a common test for measuring bone density.
Chest X-rays, MRI scans, and breast cancer tumor marker testing usually aren’t recommended for routine testing for people who have completed breast cancer treatment. However, your doctor may order these tests if you have symptoms of breast cancer recurrence.
After completing their initial treatment, some people benefit from continued drug therapy. This is often referred to as adjuvant therapy.
People with hormone receptor-positive breast cancers might receive adjuvant hormone therapy to reduce the risk of recurrence. These medications are often taken for at least five years.
Although hormone therapy helps reduce the risk of recurrence, it can come with bothersome side effects, including:
Some members of MyBCTeam share their excitement when their adjuvant therapy ends. One member wrote, “Found out yesterday that after five years of treatment, I am completely done. No more treatment. I can’t believe it. No more letrozole, no more Lupron, no more Zoladex, no more radiation! So happy!!!”
Breast cancer treatments can have side effects that continue for months or years. Some survivors even develop new side effects months or years after finishing treatment.
Long-term side effects of breast cancer treatment include:
“I’m a triple-negative breast cancer survivor. It’s been five years for me, and I thank God every day. 🙏I’m not back to normal, though,” wrote a MyBCTeam member. “Every day is a blessing — I’ll admit to that — but the lingering pain is a constant reminder that I’m a survivor. ❤”
At the 10-year mark after breast cancer treatment, it’s usually recommended that people who are still taking adjuvant therapy now stop. Follow-up care with your doctor will focus on your age-appropriate screening and preventive care.
One MyBCTeam member shared, “Over 10 years now, and I’m still doing great! Retired and happy spending time with family!”
Some people with a high risk of breast cancer recurrence may take hormone therapy for up to 10 years.
A test called the breast cancer index can help your doctor predict your risk of breast cancer returning after five and 10 years. People classified as high risk may benefit from taking hormone therapy for longer than five years. Your doctor can help you weigh the risks and benefits of continuing adjuvant therapy.
Routine replacement of breast implants is not necessary. However, between 40 percent and 70 percent of people who have breast reconstruction surgery have reoperations to modify, remove, or replace their implants during the next eight to 10 years.
A MyBCTeam member reflected, “We all worry about breast cancer coming back — the if, the when, and the where.”
The risk of recurrence is about 10 percent for all breast cancers, according to a study published in the Journal of Clinical Oncology, and it’s highest in the first five years after the initial cancer diagnosis. Recurrence is most common in the first two years after treatment, but the risk steadily declines each year for about 10 years. After 10 years, the risk of recurrence doesn’t change much.
Some types of breast cancer are more likely to recur than others. Talk to your doctor about your risk of recurrence.
Some breast cancer survivors not only face the risk of recurrence but also can develop a new, unrelated cancer. This is referred to as second cancer. Cancer treatments and genetic risk factors can raise the risk of some cancers, including:
Although the diagnosis and treatment of breast cancer often negatively affect mental health and physical health, most people have a good quality of life after completing breast cancer treatment. Researchers have reported that physical function and the ability to deal with daily tasks greatly improve in the first year after breast cancer treatment ends.
Factors that lower health-related quality of life in the first five years after treatment include:
Quality of life for people who have had breast cancer is similar to that of people who haven’t had the disease. One study found that although some survivors still have cognitive and financial issues related to breast cancer treatment, their quality of life closely matches that of people their age without cancer.
MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 60,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.
Have you completed breast cancer treatment? How has your quality of life been since you finished? If you’ve reached the five- or 10-year mark, share your experience about life after breast cancer treatment in the comments below, or start a conversation on your Activities page.
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Richard LoCicero, M.D.
has a private practice specializing in hematology and medical oncology at the Longstreet Clinic Cancer Center, in Gainesville, Georgia. Review provided by VeriMed Healthcare Network.
Learn more about him here.
Amanda Jacot, PharmD
earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014.
Learn more about her here.
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