What after the treatment?

Your treatment is complete, but that does not automatically mean you are cured. Breast cancer, like any other cancer, can resurface unexpectedly. All treatments notwithstanding, cancer cells may still remain in your body. They can remain in a dormant state for years and for unknown reasons become active again and cause a metastasis. This is called a recurrence or relapse. That's why it's important that you are followed up, with regular checkups. Moreover, you need time to recover from the heavy treatment process: radiation, chemo, surgery and hormone therapy do not go easy on you. Perhaps you tire more quickly, suffer from a faltering memory or have trouble concentrating. That, too, deserves monitoring.

Checks

After treatment, you will be followed up for at least five years with regular checkups consisting of an interview, physical examination, a mammogram and ultrasound, and a blood test. Guidelines recommend checkups every three to six months in the first three years, every six to 12 months in the following two years, and annually thereafter.In the first five years after treatment, the risk of relapse is highest. The frequency of checkups can be adjusted based on the individual risk profile and in consultation with the treatment team.Women with a hereditary predisposition to breast cancer, for example, receive more frequent MRI scans. If you have specific symptoms, additional testing may be required.  

If you are still cancer-free after five years, the chance of relapse has become very small. Still, it is not completely out of the question that after ten, and very exceptionally after twenty years, you may still have metastases.

Metastases

Of all people with breast cancer, one in five will experience relapse or metastasis. Not everyone is at the same risk. Following factors increase the chance:

• Type of breast cancer. Aggressive (fast-growing) cancers spread faster. Certain breast cancers also spread faster. A triple-negative breast cancer has a higher risk of relapse than a hormone-sensitive breast cancer.

• Size of tumor at time of diagnosis. Larger tumors are associated with a greater risk of relapse.

• Condition of the axillary glands. If axillary glands were found to have cancer cells during your initial treatment, then there is a greater chance of relapse.

Metastases from breast cancer can occur in several places in your body and also in several places at once. Breast cancer usually spreads to the bones, liver, lungs, peritoneum and brain. Metastases give rise to symptoms over time. For example, metastases in the bones cause pain and reduce mobility. Metastases in the lungs can trigger cough and shortness of breath; those in the peritoneum sometimes cause fluid accumulation in the abdomen, nausea and abdominal pain.  

Metastases always retain the name the original cancer. When you have metastases in the bones, for example, you don't have bone cancer but you do have metastatic breast cancer. After all, the cancer cells found there are breast cancer cells. Treatment is largely similar to that for breast cancer. Checkups do not routinely look for metastases because it makes little difference to the prognosis.  

Metastatic breast cancer is almost never curable, but it is treatable.Treatments can inhibit the growth of metastases and reduce symptoms.

Long-term effects of treatment

The effects of breast cancer treatment often do not stop the moment therapy ends. Even months or even years later, symptoms may persist that affect your daily life. Fatigue, lymphedema (a "fat arm") and memory or concentration problems - the so-called "chemo brain" - are common examples. This text tells you what long-term effects may occur and what steps you can take to better cope. Read more about long-term effects here.

Work resumption

Returning to work after breast cancer is a meaningful step - in all respects - that deserves proper attention and support. However, reintegration is not always easy. It is very important for patients to be well informed right from the start of treatment, and hospital care providers, in addition to family, employer and colleagues, play an important role in this.

With Pink MondayPink Ribbon is fully committed to facilitating work resumption.

Having a child after breast cancer

Every year, more than 500 Belgian women under the age of 40 develop breast cancer. They no longer have to draw a line under their desire to have children thanks to developments in oncofertility, which is the field that deals with breast cancer and fertility.  

Read Santukha's testimony.

Family Hope

In 2013, 7 Belgian universities, with the support of Pink Ribbon, established an online platform to provide patients, their loved ones and physicians with information on options for maintaining fertility during and after breast cancer treatment. The information from this plaform, Family Hope, was later integrated and updated on the Pink Ribbon website. Dr. Isabelle Demeestere, coordinator of the Family Hope project and head of the oncofertility unit at ULB, stresses the importance of accurate information for patients and the need to constantly update this information.

Breast reconstruction

Breast cancer leaves visible marks. You lose part or all of your breast. The surgery is an attack on your body image and sense of femininity. Yet not all women opt for breast reconstruction. In older age, it is often no longer necessary, because of the new surgery. Younger women are more often won over for a new breast. Especially the carriers of breast cancer gene. Of this group, the majority opt for preventive removal of both breasts(mastectomy) with immediate reconstruction, in one operation. Read more here.