As you enter the survivorship phase of your treatment, you may be wondering about the chances of the cancer returning. The risk of recurrence is different for each breast cancer survivor, and depends on many factors, including the type of breast cancer you were originally diagnosed with (e.g., hormone-receptor-positive vs. hormone-receptor-negative breast cancer). Understanding your individual risk factors will help you and your doctor develop an appropriate treatment plan for the coming months and years. Read below for 3 steps you can take to help you understand your individual risk of recurrence.
- Develop a Follow-up Care Plan
After cancer treatment ends it is recommended that you continue to see your health care team for regular medical checkups. At each appointment, your doctor will monitor your overall health and recovery, help manage any lingering or long-term side effects from your treatment, and keep a close eye on your cancer to make sure it doesn’t return. Recently, the American Cancer Society (ACS) and the American Society of Clinical Oncology (ASCO) issued guidelines for monitoring breast cancer survivors for recurrent disease, with recommendations on surveillance, screening, and managing the physical and emotional effects of treatment. Talk to your doctor to develop a personalized follow-up care plan.
- Get Screened
During follow-up appointments, your doctor may recommend certain lab tests, such as imaging and blood work, to check for evidence of cancer recurrence or to screen for secondary cancers. Diagnostic procedures may follow if your doctor suspects your breast cancer has returned based on your symptoms and/or previous test results. This information, along with your individual risk factors, can help guide you and your doctor on a treatment plan going forward.
Other screening tests may be used to monitor any lasting or long-term side effects from your anti-estrogen therapy. For example, bone mineral density (BMD) screening is recommended after treatment with aromatase inhibitors, since the drugs can cause osteoporosis. Likewise, women who have taken tamoxifen should have follow-up pelvic exams/pap smears because the drug can increase the risk of uterine cancer.
ASCO and the National Comprehensive Cancer Network (NCCN) recommend this screening schedule for breast cancer survivors.
- Ask About Genomic Testing to Understand your Personal Risk of Recurrence
If you were diagnosed with estrogen receptor-positive (ER+) breast cancer, you probably know it’s not just a 5-year disease, and that the risk of recurrence continues over time. This is why some patients may be recommended to continue anti-estrogen therapy for an additional 5-10 years. However, not every woman who extends anti-estrogen treatment beyond 5 years will benefit, and patients on extended anti-estrogen treatment can experience significant side effects and long-term safety risks from these medications. It is important for you to know about your individual risk of recurrence and all available treatment options. Ask your doctor about a genomic test that provides a personalized percent risk of your cancer returning beyond 5 years. The test also examines the genetic makeup of your original tumor to identify your likelihood to benefit from extending anti-estrogen therapy after 5 years . This information can help you and your doctor make a more informed treatment decision for the next phase of your breast cancer journey.
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