Late effects of breast cancer

Most women have side effects during and for a few weeks after treatment for breast cancer. But sometimes certain side effects may not go away and become permanent. These are called long-term effects.

Other women may develop side effects months, or even years, after treatment. We call these late effects and this includes any long-term effects too. Not everyone will have late effects.

Different treatments can cause different effects. For example, surgery and radiotherapy sometimes cause swelling in the arm (lymphoedema), or limited arm and shoulder movement. Chemotherapy can cause pins and needles in the hands and feet, called peripheral neuropathy. Certain chemotherapy drugs and a targeted therapy drug called trastuzumab may increase the risk of heart problems. Hormonal therapies can cause bone thinning.

There are things that you can do to manage late effects. Let your cancer doctor or nurse know about side effects that haven’t gone away or if you have new symptoms.

Late effects

This information is for women who experience:

  • side effects that continue for six months or longer after treatment for breast cancer
  • delayed late effects which begin months or years after treatment.

We describe the possible effects and how they can be improved or managed. We’ve included information on positive lifestyle changes, which can help to reduce the risk of some late effects. There’s also information about coping with sexual and emotional difficulties that women may experience.

Most women have side effects during treatment for breast cancer and for a few weeks after. Usually, these effects gradually ease and eventually disappear. But some women may have side effects that continue months after treatment and that occasionally become permanent. Other women may develop delayed late effects of treatment months or years later.

Not everyone experiences long-term or late effects and many get better over time. How likely you are to have problems, if at all, depends on different factors, such as the type of treatment you’ve had.

Doctors and researchers look at ways of making sure women get the best treatment for breast cancer with as few side effects as possible.

Although this information is addressed to women, some of the information may help men who are experiencing late effects of breast cancer treatment. Breast cancer in men is rare and there isn’t a lot of specific information available. However, men receive similar breast cancer treatments to women and experience some of the same late effects.

There are often things that can be done to manage or treat long-term or late effects. Let your cancer doctor or nurse know if side effects you developed during treatment aren’t going away, or if you develop new symptoms or problems after treatment is over.


Long-term and late effects

You may come across different terms to describe side effects that happen or are still present after treatment is over.

There are two commonly used terms:

  • long-term effects
  • late effects.

Long-term effects begin during or shortly after treatment and don’t go away in the six months after treatment. They may go away eventually on their own, with symptoms gradually reducing for up to a year or two after treatment ends. Sometimes long-term effects are permanent.

Late effects are a delayed response to treatment. They don't appear during treatment, but can happen months or even years later.

In this information we use the term late effects to include both long-term and late effects.

There are often things that can be done to manage or treat long-term or late effects. Let your cancer doctor or nurse know if side effects you developed during treatment aren't going away, or if you develop new symptoms or problems after treatment is over.


Treatments for breast cancer

The main treatments for breast cancer are surgery, radiotherapy, chemotherapy, hormonal treatment and newer targeted treatments, such as trastuzumab (Herceptin®).

Surgery and radiotherapy to the breast, especially involving the armpit (axilla), can result in breast and chest pain, limited movement of the shoulder or arm, or swelling of the arm (lymphoedema). Women who've had part of the breast removed followed by radiotherapy may find the treated breast shrinks slightly over time so the breasts are a different size from each other.

Chemotherapy may cause an early menopause, and some chemotherapy drugs can cause changes in sensation, such as pins and needles or numbness in your hands and feet.

Hormonal therapies can cause side effects similar to menopausal symptoms and some may cause joint pain. Trastuzumab (Herceptin) and some chemotherapy drugs can cause changes in the way the heart works.

Cancer treatment can also cause more general changes in how you feel. You may be more tired than usual for several months after treatment or have difficulty concentrating or remembering things. These effects may improve over time, but some are permanent. Most women have mild treatment effects which eventually go away over time.

Treatment for breast cancer is constantly developing and women are living for longer as a result of improved treatments. We're learning more about late effects and how they can be managed. Doctors and researchers are trying to make sure that women get the best treatment with as few side effects as possible.