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Generally, someone from your oncology team will see you every 3-4 months during the first two or three years. While in active treatment it is very common to be seen by several of your cancer specialists. Soon, your medical oncologist, radiation oncologist and/or breast surgeon will each need to see you no more than once or twice a year. Whenever possible, spacing these visits out from each other throughout the year allows for optimal follow-up. You may also be seeing a plastic surgeon on a separate schedule to continue or complete various reconstructive procedures.
During this time period, it is important that you maintain a relationship with your primary care provider (PCP), including an internist and/or a gynecologist. This person will be responsible for your long-term overall health and wellness beyond your breast cancer diagnosis. If you do not have a PCP or have been unsatisfied with the care you have previously received, ask your oncologist to suggest someone to you.
And be sure to provide your PCP with the survivorship care plan that you and your oncologist created. This plan is essential for coordinating medical services and ensuring you receive the best possible long-term care.
Most radiation oncologists and surgeons will stop seeing you sometime during this time period. Physical exams will often decrease to one to two times a year. If you are still receiving some form of endocrine therapy for breast cancer, you will continue to see your medical oncologist once or twice a year.
Estrogen receptor (ER) status describes whether or not your cancer is fueled by estrogen. If your cancer uses estrogen as fuel, it is called estrogen receptor positive (ER-positive). Likewise, if your cancer is not fueled by estrogen, it is called estrogen receptor negative (ER-negative). How your cancer interacts with estrogen influences treatment choices and may also impact how quickly your cancer could recur. Most recurrences in patients with ER-negative disease occur early on and often elsewhere in the body. Patients with ER-positive breast cancer have a remaining small risk of recurrence that extends beyond five years. Women who have had ER-positive disease and have had their ovaries removed (bilateral oophorectomy) or their ovaries no longer work (menopause), may opt to take oral medications called aromatase inhibitors as endocrine therapy.
Once you complete 5 or more years of endocrine therapy, you may no longer be seeing your cancer specialists on a regular basis. However, it is critical that you continue with your annual breast imaging (e.g., mammograms) with an experienced radiology team to screen for new breast cancers. If you have been treated with a lumpectomy, imaging is needed for both breasts. After a one-sided mastectomy, imaging is only needed for the unaffected breast.
At this time, it is essential that you have an established relationship with a primary care provider. If new symptoms or concerns arise, your medical oncologist and your breast surgeon are available for an appointment if necessary. It is essential that you continue all recommended screenings and physical exams by your PCP to maintain your overall health and wellness.