A diagnosis of breast cancer marks an arduous emotional journey with physical, psychological and financial challenges. Shock and a lifetime of fear of what will happen in the future is just one aspect. Fears of financial constraints, rejection by partner, concerns about body image and social acceptance may lead to depression, anxiety and a feeling of helplessness.
Surgical removal of breast may be very traumatic to the patient, who may require several sessions of counselling and rehabilitation.
Silicon prosthesis and reconstructive surgery are some options available. Breast prosthesis may be possible about 6-8 weeks after mastectomy or radiotherapy. This can be tailor-made to suit each patient. Similarly, tailor-made wigs can be used during chemotherapy to make hair loss less evident.
Sometimes, there may be some lingering side effects of chemotherapy (some degree of cardiac enlargement, tingling in the hands / feet etc.), radiotherapy (hardness at surgery site, swelling of the arm on the operated side, blackening of the skin etc.) or hormone therapy (bony pains, generalised body ache, hot flashes, postmenopausal bleeding, blood clots etc.). Most of these can be treated medically very well.
On completion of treatment for breast cancer, some experience anxiety about recurrence and physical appearance. While on some, the entire process has a very positive impact. It teaches them to value and cherish each moment in life and learn to enjoy the small joys of life rather than running behind materialistic pleasures. It has been seen that those who take it all in a positive stride have the best outcomes!
Follow-up care after breast cancer treatment
Periodicity of follow-ups will be determined by the nature and extent of the cancer. The aim is to ensure that the cancer is in check and you have no major side effects of continuing treatment.
Doctor visits Will be scheduled every 3-6 months for the first three years after completion of active treatment. Then every 6-12 months for the next two years. After 5 years, visits are scheduled once a year. The longer you are free of cancer, the less often will be your visits to the doctor.
Mammogram If you have had breast conserving surgery, you will need a mammogram for both the breasts 12 months after surgery and completing radiation and then once a year. If you have had a mastectomy, you will need a mammogram on the other breast every year.
Pelvic examination If you have been prescribed a hormone drug like tamoxifen, you will need an annual pelvic examination as these drugs increase the risk of uterine cancer. The risk is highest in women who have gone through menopause. Inform the doctor about any unusual vaginal discharge, bleeding or spotting after menopause or spotting between periods or a change in cycle.
Other tests Blood tests, bone scans, abdominal scans, chest x-rays, PET scans, biopsy etc. may be advised if required. Sometimes, blood tumour markers like CA 15-3, CA 27-29 or CEA may be advised to rule out the spread to bones, liver or other organs.
The cure rates for breast cancer are 95% in the first stage as against 20% at 5 years for fourth stage.