What happens after treatment?

Women have regular check-ups and yearly mammograms after treatment. Your nurse will explain what to look out for in your treated breast. Contact your nurse if you notice anything new in either breast.

Breast cancer and its treatment can affect your sex life. This often improves over time but talk to your nurse if you’re still having problems. They will advise you not to use contraception containing hormones, such as the contraceptive pill or some coils.

Doctors advise women who want children to delay getting pregnant for a couple of years after treatment. Some treatments can also affect your ability to have children (your fertility). You can see a fertility specialist before treatment starts.

Some women develop swelling of the arm, called lymphoedema. Your nurse will explain how you can reduce the risk of developing this.

Certain treatments may cause an early menopause, leading to menopausal symptoms. HRT isn’t recommended but your nurse will advise you on ways of managing the symptoms.

Making positive lifestyle changes after treatment can help your body recover. For example, by being more physically active, eating healthily, or stopping smoking.

Follow-up

After treatment, you’ll usually have regular check-ups and yearly mammograms. Your appointments will be every few months at first, but eventually they may be once a year. Appointments are a good opportunity for you to talk to your doctor or nurse about any concerns you have. If you notice any new symptoms between appointments, you can contact your doctor or nurse for advice.

Instead of routine appointments, some women are given information on what to look out for by their breast care nurse. They are asked to contact their nurse or cancer specialist if there’s anything they’re worried about. Some women may have their follow-up appointments at a nurse-led clinic and only see their cancer specialist if something needs to be checked further.

Many women find they get anxious for a while before the appointments. This is natural. It can help to get support from family, friends or one of the organisations listed on our database. You can also contact the Macmillan Support Line on 0808 808 00 00.


Breast awareness

Although you’ll have yearly mammograms, it’s still a good idea to be aware of what’s now normal for you. Your treated breast will look and feel different depending on the treatment you’ve had.

Your breast care nurse can tell you what you should expect and what to look out for. It’s also important to be aware of what to look out for in your untreated breast.

If you notice anything unusual between appointments, contact your cancer doctor or breast nurse straight away.


Sexuality

Breast cancer, its treatments and side effects may affect your sex life and your feelings about yourself as a woman.

Difficulties often gradually improve after treatment, although for some women it may take longer. There may need to be a period of adjustment for you and your partner. You may feel insecure and worry whether or not your present or a future partner will find you sexually attractive. It can help to try and talk about it if you feel things are awkward between you.

Cuddles, kisses and massages can show how much you care for someone even if you don’t feel like having sex. You can wait until you and your partner feel ready – there’s no right or wrong time.

We have more information and tips on coping in our section on sexuality.

Let your doctor or nurse know if any difficulties with your sex life don’t improve. They may be able to reassure you and can offer further help and support.

If you feel uncomfortable talking to your doctor or nurse, you can call us on 0808 808 00 00. Some people may find it helpful to talk to a sexual therapist. You can contact a therapist through the College of Sexual and Relationship Therapists.


Contraception

Your doctor will advise you not to use contraception that contains hormones, such as the pill or coils (intra-uterine devices) that release hormones. Coils that don’t contain hormones or barrier methods, such as condoms or the cap, are usually the most suitable. Your breast care nurse can give you advice.


Pregnancy

Having a family can be an important part of moving on with life after cancer. Some women, particularly if they are under 35 don’t have difficulties getting pregnant naturally after treatment.

Doctors sometimes advise women to wait for two years. This is because it’s during this time breast cancer is most likely to come back. But waiting also gives women time to recover from treatment. Studies show getting pregnant after breast cancer doesn’t increase the risk of it coming back. It’s always a good idea to talk to your cancer doctor if you’re thinking about getting pregnant.


Effects on fertility

Some breast cancer treatments can affect your ability to have children (fertility). Chemotherapy can bring on an early menopause, especially in women who are closer to the menopause. But in younger women, even though their periods may stop during treatment, they may start again after it’s finished.

It’s important to talk to your cancer specialist about your fertility before your treatment starts. Sometimes it may be possible to remove eggs from your ovaries before treatment. These can be fertilised with a partner’s sperm, and the embryos (fertilised eggs) can be frozen and stored to use later. Women without a partner can have their eggs frozen and stored.

Becoming infertile can be very hard for women to live with, whether or not they already have children. Some women find it helpful to talk through their feelings with a trained counsellor. If you need more specialist help, ask your doctor or nurse to arrange this for you.

We have more information in our section on coping with the effects on fertility.


Lymphoedema

Lymphoedema is a swelling of the arm that sometimes happens after surgery or radiotherapy to the lymph nodes in the armpit. It can develop months or years after treatment. If you only had a sentinel lymph node biopsy, your risk of lymphoedema is small. Women who had all or a large number of lymph nodes removed are more at risk. Having radiotherapy to the armpit as well as surgery also increases lymphoedema risk.

There are things you can do to help reduce your chances of developing lymphoedema.


Early menopause or menopausal symptoms

Some treatments can cause an early or temporary menopause. Hormonal therapies can cause side effects which are the same as menopause symptoms.

Doctors don’t recommend hormone replacement therapy (HRT) because it contains oestrogen, which could encourage breast cancer cells to grow. If a woman’s menopause symptoms are severe and nothing else has helped some doctors may occasionally prescribe HRT. Women need to talk this over with their doctor so they are aware of the possible risks.

There are different ways in which menopausal symptoms can be treated. Our section on managing menopausal symptoms has more information.


Well-being and recovery

After breast cancer treatment, some women choose to make some positive lifestyle changes. It’s not to say you didn’t follow a healthy lifestyle before. But you might feel you want to focus more on making the most of your health.

Eat well and keep to a healthy weight

After treatment, it’s not unusual for women to find they’ve put on some weight. This can happen with chemotherapy and hormonal therapy, which you take for a number of years. When you’re feeling up to it, you can check with your GP if your weight is within the normal range for your height.

Our section on weight management after cancer treatment has some helpful tips.

There’s some evidence that keeping to a healthy weight after menopause may help reduce the risk of breast cancer coming back. We already know it reduces the risk of heart problems, diabetes and developing some other cancers. Try to:

  • only eat as much food as you need
  • eat a balanced diet with lots of fruit and vegetables
  • eat less saturated fat and sugar
  • become more physically active.

There’s information about healthy eating in our section on eating well after cancer treatment.

Get physically active

Being physically active helps to keep your weight healthy and can reduce stress and tiredness. It helps to keep your bones strong and your heart healthy. There is some evidence that regular physical activity may help to reduce the risk of breast cancer coming back. We have a section about physical activity and cancer treatment, which has more information.

Look after your bones

Aromatase inhibitors and treatments that cause early or temporary menopause increase the risk of bone thinning (osteoporosis). This is because oestrogen helps keep bones healthy and strong. Keeping physically active, such as walking, eating a healthy diet with enough calcium and vitamin D, and stopping smoking keeps bones healthy.

Our section about bone health has more information.

Look after your heart

Some treatments may increase the risk of getting heart problems later in life. Look after yourself by keeping physically active, eating healthily, not smoking and sticking to sensible drinking guidelines. The British Heart Foundation has helpful information and advice.

Stop smoking

If you smoke giving up is one of the healthiest decisions you can make. Smoking increases your risk of bone thinning (osteoporosis) and is a major risk factor for smoking-related cancers and heart disease. Our section on giving up smoking has more information and tips to help you quit.

Stick to sensible drinking

Stick to sensible drinking guidelines, which recommend that women drink less than two units a day or 14 a week. Try to have a few alcohol free days a week.