Breast Cancer Survivorship: Post-Diagnosis/Screening and Recurrence

Breast cancer survivors have an increased risk of getting a new breast cancer compared to those who have never had breast cancer. That is why it is important to get the follow-up care your doctor recommends. With proper follow-up, your doctor can keep track of how you are doing. This includes checking for and treating side effects. Follow-up care can also help ensure any recurrence of breast cancer can be found early when treatment is most effective.

The National Comprehensive Cancer Network offers these guidelines for follow-up of breast cancer treatment:

1. Have a mammogram every 12 months (for women treated with mastectomy). (For women treated with lumpectomy, have a mammogram six months after radiation therapy ends, then every 12 months.)

2. Have a physical exam 1-4 times a year (depending on your situation) for 5 years, then every 12 months.

3. Have a pelvic exam every 12 months.

4. Have a bone health exam every one to two years, depending on a person’s risk factors.

Follow-up Tests

Depending on the symptoms, blood tests (including tumor marker tests) and imaging tests (including bone scans, CT scans, PET scans and chest X-rays) may be used to check for metastases. Using these tests to check for early metastases in people with no symptoms of metastases does not increase survival. For people with no symptoms of metastases, blood and imaging tests (other than mammography) are not a standard part of follow-up care.

Learn more about medical care after breast cancer treatment: http://ww5.komen.org/BreastCancer/MedicalCareAfterTreatment.html

Breast Cancer Survivorship: Post-Diagnosis/Breast Reconstruction

Breast reconstruction can help restore the look and feel of the breast after a mastectomy. Performed by a plastic surgeon, breast reconstruction can be done at the same time as the mastectomy (“immediate”), or at a later date (“delayed”). Many women now get immediate breast reconstruction.

However, the timing depends on your situation and the treatment you will have after surgery. Not all women can have immediate reconstruction. It is important to discuss your options with your plastic surgeon, breast surgeon and oncologist (and your radiation oncologist if you are having radiation therapy).

There is no one best reconstruction method. There are pros and cons to each. For example, breast implants require less extensive surgery than procedures using your own body tissues, but the results may look and feel less natural. However, there are fairly few complications with any of the current techniques, especially when a woman is properly selected for a procedure.

Most breast reconstruction methods involve several steps. Both immediate and delayed reconstructions require a hospital stay for the first procedure. However, follow-up procedures may be done on an outpatient basis.

Learn more about breast reconstruction: http://ww5.komen.org/BreastCancer/BreastReconstruction.html

Survivorship: You Are Not Alone

Other breast cancer survivors share similar fears and concerns. No matter how long ago you completed treatment and no matter the struggles you face, there are likely other people who have been where you are today.

Sharing experiences and advice with other survivors may be helpful. You can find other survivors through Komen’s Message Boards.

Your doctor can also tell you how to find a local support group.

After treatment ends, there are many ways to stay active in the breast cancer community. Getting involved can be personally rewarding and can impact the lives of others.

Survivorship: Psychosocial Factors and Breast Cancer

One in eight women in the U.S. will be diagnosed with breast cancer in her lifetime, and more than 40,000 women and 440 men in the U.S. will die from the disease this year.

It is no surprise that, when faced with this news, women possibly experience shock, fear, sadness, disbelief or other feelings of psychosocial distress. Many women are able to adjust to and manage the disease, survivorship and their “new normal.” Some women will experience times of persistent psychosocial distress and would benefit from interventions. Intervention is important because distress can interfere with a woman’s ability to cope with cancer treatment and can extend along the continuum from common feelings of vulnerability fear, and sadness, to true depression, anxiety, panic and feeling isolated.

Coping with a Breast Cancer Diagnosis

• Learn about breast cancer at your own pace. Get information about clinical trials, treatment options and side effects. Doctors can make suggestions, but decisions should be made together.

• Seek professional help if you need help managing your issues with breast cancer and how to cope with your feelings.

• Talk to your doctor honestly about your breast cancer journey.

• Be patient. Coping with breast cancer requires time, acceptance, a fighting spirit and support.

• Lean on your network of family and friends. They can help:

• Lend support from diagnosis through treatment and beyond

• With day-to-day tasks

• Gather information for you about breast cancer

Coping with Fear of Recurrence

It is normal to have thoughts and concerns about breast cancer coming back breast. Fears of recurrence often peak right after treatment, but they can happen at an time. You can take control of your fears and learn effective triggers and coping strategies to keep these fears from consuming you. Some of these strategies include:

• Get and stay informed. Learn about your cancer and risk of recurrence, continue your follow-up-care plan and take care of yourself.

• Remove any blame. Never blame yourself for your cancer diagnosis. Cancer does not choose to punish people and it doesn’t discriminate. Cancer can happen to anyone.

• Talk to your doctor and begin an appropriate exercise program. It can improve your mood and make you feel healthy, confident and strong.

• Find ways to relax like yoga, meditation, prayer, etc.

• Acknowledge your feelings. Talk to family, friends or other survivors. Journal, craft, or find creative ways to give voice to your emotions.

• Focus on the positive. Find ways to stay hopeful and use your energy to stay as healthy as possible.

• Control what you can. Empower yourself by taking an active role in your healthcare team.

Learn more about breast cancer recurrence and maintaining quality of life: http://ww5.komen.org/AboutBreastCancer/QualityofLifeTopics/SurvivorshipTopics/SurvivorshipTopics.html

Breast Cancer Survivorship: Support Community

A breast cancer diagnosis can be confusing, overwhelming and scary. Make sure that you build and search for a support community to support you in your journey. The support of others who care about you and your well-being can give you the strength to cope and retain a sense of control during this challenging time.

At Komen, we believe anyone who has been diagnosed with breast cancer is a survivor, from diagnosis through treatment and beyond. The National Cancer Institute’s Office of Cancer Survivorship also defines breast cancer survivor in this way.

Getting the Support You Need

There are three main types of support: informational, emotional and practical. You may need different kinds of support at different times and from different people.

Informational Support provides you with information about breast cancer. This might include finding facts about your type of breast cancer or gathering information about your treatment options.

Emotional Support looks after your emotional well-being. Emotional supporters listen to you, give you the chance to express your feelings and just be there when you need a friend.

Practical Support helps you with specific tasks. This might include rides to appointments, help with cooking or cleaning or going to the doctor with you to take notes. It may also mean seeking out any short-term financial assistance available.

The Komen breast care helpline- 1-877-GO KOMEN (1-877-465-6636) provides breast health and breast cancer information to anyone with questions or concerns about breast cancer.

Building your Support Community

Write down the names of people (co-survivors) who might support you in different ways. Your list may include your partner, children, other family members, friends, support group members, co-workers, clergy, neighbors or even health care providers. Look outside your existing network of support people, too. Have you met someone who has experienced breast cancer that you could reach out to?

Write down what kind of support you would like most from each person on your list. For instance, you may want your doctor to give you informational support, your best friend to give you practical support, your sister to give you emotional support, and your partner to give you all three types of support.

Tell each person exactly what he or she can do to help you and be specific. They can help with laundry, the bills, cleaning, etc. Sometimes all it takes is asking.

Have a “back-up” support person. Although it is true that you are the one who has breast cancer, the special people in your life have also been affected by your illness. Sometimes co-survivors will need to deal with their own feelings before they can support you.

Benefits of Co-Survivor Support

• Reduced anxiety and psychological distress
• Reduced depression and feelings of pain
• Improved mood and/or self-image
• Improved ability to cope
• Improved feelings of control

Support groups are also an important resource for breast cancer survivors. They are designed to increase the support network of the people in the group.  Your doctor can also tell you how to find a local support group.

Learn more: http://ww5.komen.org/BreastCancer/SupportIntroduction.html

Breast Cancer Survivorship: Post-Diagnosis

Breast Reconstruction

Breast reconstruction can help restore the look and feel of the breast after a mastectomy. Performed by a plastic surgeon, breast reconstruction can be done at the same time as the mastectomy (“immediate”), or at a later date (“delayed”). Many women now get immediate breast reconstruction.

However, the timing depends on your situation and the treatment you will have after surgery. Not all women can have immediate reconstruction. It is important to discuss your options with your plastic surgeon, breast surgeon and oncologist (and your radiation oncologist if you are having radiation therapy).

There is no one best reconstruction method. There are pros and cons to each. For example, breast implants require less extensive surgery than procedures using your own body tissues, but the results may look and feel less natural. However, there are fairly few complications with any of the current techniques, especially when a woman is properly selected for a procedure.

Most breast reconstruction methods involve several steps. Both immediate and delayed reconstructions require a hospital stay for the first procedure. However, follow-up procedures may be done on an outpatient basis.

Screening/Re-diagnosis

Breast cancer survivors have an increased risk of getting a new breast cancer compared to those who have never had breast cancer. That is why it is important to get the follow-up care your doctor recommends. With proper follow-up, your doctor can keep track of how you are doing. This includes checking for and treating side effects. Follow-up care can also help ensure any recurrence of breast cancer can be found early when treatment is most effective.

The National Comprehensive Cancer Network offers these guidelines for follow-up of breast cancer treatment:

1. Have a mammogram every 12 months. (For women treated with lumpectomy, have a mammogram six months after radiation therapy ends, then every 12 months.)

2. Have a physical exam every three to six months for the first three years, every six to 12 months for years four and five, then every 12 months.

3. Have a pelvic exam every 12 months if taking tamoxifen and have not had the uterus removed (have not had a hysterectomy).

4. Have a bone health exam every one to two years, depending on a person’s risk factors.

Follow-up Tests

Depending on the symptoms, blood tests (including tumor marker tests) and imaging tests (including bone scans, CT scans, PET scans and chest X-rays) may be used to check for metastases. Using these tests to check for early metastases in people with no symptoms of metastases does not increase survival. For people with no symptoms of metastases, blood and imaging tests (other than mammography) are not a standard part of follow-up care.

Learn more about medical care after breast cancer treatment: http://ww5.komen.org/BreastCancer/MedicalCareAfterTreatment.html

We are celebrating National Breast Cancer Awareness Month. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

Breast Cancer Survivorship: Intimacy

Being diagnosed with breast cancer can take a physical toll on your body, not to mention your intimate and sexual health. Breast cancer and treatment for breast cancer can sometimes make it difficult to be sexual and intimate with another person, and that is okay and natural.

Self-Image

A woman’s breasts symbolize so many things, including motherhood, sexuality and being a woman. For some women, breasts now represent cancer. Most women, and their partners, will need to take time to grieve the loss of (or changes in) their breast(s).

Joining a support group may help you cope with the changes in your body and self-image. Remind yourself that healing takes time and at some point, you will become more comfortable with your new normal.

Accepting yourself as you are is all part of the process.

How to Talk with Your Partner

While there is no such thing as a perfect time to talk, certain times are better than others. Choose a moment when you are alone and relaxed. When you feel comfortable, give yourself and your partner permission to talk about your feelings, both good and bad. Above all else, be honest.

Your biggest fears. You may not feel pretty or worry that your partner finds you less attractive. You may be afraid your partner will reject or leave you due to your breast cancer.

Your partner’s fears. Your partner may be afraid of physically hurting you during sex. He/she may be confused or unsure of the best way to show support and affection and is waiting on you for cues on when to resume an intimate and/or sexual relationship.

Birth control. Treatments such as radiation or chemotherapy and tamoxifen can cause birth defects, so it is import to talk to your partner about birth control. After treatment, do not assume that you can no longer become pregnant.

Your “new” sex life. Breast cancer may change what you like to do and how you like to be touched during sex. You may not even want to have sex for a while, so it is important to talk to your partner about how you are feeling.

Other Things You Can Do

Get romantic. Bring romance back by planning a candlelight dinner, taking a bubble bath or other romantic gestures. Take the time to nurture your sexuality.

Go slow. Kissing and touching can provide pleasure and help with intimacy. Do not rush into something until you feel comfortable with it.

Get comfortable. Sex may be painful because of changes in your body, due to breast cancer treatment.

Try using water-based lubricants just before sex. To help with vaginal dryness, try an estrogen-free vaginal moisturizer. These products are available over the counter without a prescription. Since they do not contain estrogen, they’re safe for breast cancer survivors. If vaginal dryness is still a problem, contact your doctor.

Try something different. Change your sexual routine; try new things and have fun!

Get some advice. Consider seeking advice from a marriage counselor, sex therapist or joining a support group. You can go with your partner or by yourself.

Make sure to share this information with your partner. Getting the intimacy you need should not be your responsibility alone.

Learn more: http://ww5.komen.org/BreastCancer/SexandSexuality.html

We are celebrating National Breast Cancer Awareness Month. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

Breast Cancer Survivorship: Psychosocial Factors and Breast Cancer

One in eight women in the U.S. will be diagnosed with breast cancer in her lifetime, and more than 40,000 women and 440 men in the U.S. will die from the disease this year.

It is no surprise that, when faced with this news, women possibly experience shock, fear, sadness, disbelief or other feelings of psychosocial distress. Many women are able to adjust to and manage the disease, survivorship and their “new normal.” Some women will experience times of persistent psychosocial distress and would benefit from interventions.

Intervention is important because distress can interfere with a woman’s ability to cope with cancer treatment and can extend along the continuum from common feelings of vulnerability fear, and sadness, to true depression, anxiety, panic and feeling isolated.

Coping with a Breast Cancer Diagnosis

• Learn about breast cancer at your own pace. Get information about clinical trials, treatment options and side effects. Doctors can make suggestions, but decisions should be made together.

• Seek professional help if you need help managing your issues with breast cancer and how to cope with your feelings.

• Talk to your doctor honestly about your breast cancer journey.

• Be patient. Coping with breast cancer requires time, acceptance, a fighting spirit and support.

• Lean on your network of family and friends. They can help:

• Lend support from diagnosis through treatment and beyond

• With day-to-day tasks

• Gather information for you about breast cancer

Coping with Fear of Recurrence

It is normal to have thoughts and concerns about recurrence (being re-diagnosed with breast cancer). Fears of recurrence often peak right after treatment, but they can happen at any time. You can take control of your fears and learn effective triggers and coping strategies to keep these fears from consuming you. Some of these strategies include:

• Get and stay informed. Learn about your cancer and risk of recurrence, continue your follow-up-care plan and take care of yourself.

• Remove any blame. Never blame yourself for your cancer diagnosis. Cancer does not choose to punish people and it doesn’t discriminate. Cancer can happen to anyone.

• Talk to your doctor and begin an appropriate exercise program. It can improve your mood and make you feel healthy, confident and strong.

• Find ways to relax like yoga, meditation, prayer, etc.

• Acknowledge your feelings. Talk to family, friends or other survivors. Journal, craft, or find creative ways to give voice to your emotions.

• Focus on the positive. Find ways to stay hopeful and use your energy to stay as healthy as possible.

• Control what you can. Empower yourself by taking an active role in your healthcare team.

Learn more: http://ww5.komen.org/BreastCancer/QualityofLife.html

Learn more about breast cancer recurrence: http://ww5.komen.org/BreastCancer/FearofRelapse.html

We are celebrating National Breast Cancer Awareness Month. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.