Post breast cancer treatment monitoring aims for the earliest possible detection of any cancer recurrence locally or regionally or any cancer metastasis, whilst trying to maintain the patient’s and the family’s quality of life.
Once the first phase of treatment is completed, it is recommended that patients visit the treatment team every 6 months for monitoring over a period of 5 years and annually thereafter.
The follow-up monitoring should also include the patient’s family health professional. Close collaboration between the health professionals ensures the best possible monitoring and avoids unnecessary tests.
To this end a special treatment history notebook may be established which is filled in by one of the treatment team at each visit. The patient keeps this and can use it to inform other health professionals, as and when needed, of medication history, test results etc.
Consultations will most likely involve:
- A clinical examinations of the breasts and lymph node areas,
- An annual mammography with a breast and axillary ultrasound
- And under certain circumstances an examination for any abnormalities that could indicate recurrence; these are:
- Presence of tumour markers CA 15-3 & ACE (carcinoembrionic antigen),
- Certain liver function results,
- Results from an abdominal pelvic cavity ultrasound test,
- Results from an x-ray of the thorax.
Follow-up monitoring is carried out at the clinic where the initial treatment was given and is fine tuned to the level of the initial illness. Furthermore any side effects can be managed by the same team in the same place.
A breast MRI (magnetic resonance imaging) scan may be used when there: there is a question over the mammogram results, there is cancer recurrence in the same tissue area that underwent surgery, the patient is a high cancer recurrence risk, and the patient presents genetic mutation in gene BRCA1 or 2.
After several years in complete remission, younger patients may be able to bear children, though the ICM team and the professionals monitoring the patient should all be in agreement as to the suitability of pregnancy. In all cases, at the outset of cancer treatment, it is important to discuss all the options open to younger women for preserving their fertility.
Most patients are cured and can look forward to a stress free life. It is all the more important to maintain regular monitoring. (For more information please see the AFACS association (French post breast cancer association): www.afacs.fr and also l’HAS (French National Authority for Health) website on breast cancer: www.has-sante.fr)