Follow-Up Care After Treatment for Male Breast Cancer
After treatment for breast cancer, it is important for you to follow your provider’s plan for follow-up care. This article reviews the most common follow-up recommendations. You should talk with your care team about your specific follow-up plan.
Screening for recurrence (cancer coming back) or new cancers
- If you had a lumpectomy, you should have a mammogram on the breast that had cancer once a year. If you had a mastectomy, this is not needed.
- If you have a known genetic changes, you should have a mammogram done on the opposite breast once a year.
- If you had surgery, your care team will monitor for lymphedema changes.
- You should be seen by your cancer care team 1-4 times a year for 5 years, and then once a year after that.
- Talk with your provider about genetic testing if you have not already had this testing. Be sure to tell your provider if you have any new, unusual symptoms, and/or symptoms that don't go away. These can be new lumps, pain, difficulty breathing, or frequent/persistent headaches.
- Get other cancer screening tests based on your age and health history. These can include colorectal or prostate cancer screening or checks for skin cancer.
- Depending on the treatment you had, your heart may be monitored with electrocardiograms (ECG) to check your heart rhythm.
Hormone Therapy Side Effects
Hormone therapy is often taken for 5-10 years. It is important to talk with your provider about any side effects so they can help you with them. This can help you stay on these medicines for the planned length of time.
Hormone therapies such as tamoxifen, aromatase inhibitors (AIs), and GnRH Analogs (Lupron) often cause hot flashes. A hot flash is a sudden feeling of warmth/heat, often in your upper body (face, neck, chest). It can make you flushed (skin is red) or make you sweat. A hot flash tends to last a few minutes. Helpful tips to cope with hot flashes are to:
- Stay away from triggers such as warm rooms, spicy, caffeinated, or alcohol-containing foods or drinks.
- Wear breathable clothing in layers, and keep your room/environment cool with fans, open windows, or air conditioning.
- Ask your care team about antidepressant medications. Sometimes these can help lessen hot flashes.
Other side effects of Tamoxifen
Other common side effects of tamoxifen can be:
- Weight gain.
- Loss of interest in sex (called low libido).
- Issues with memory.
- Mood changes or depression.
- Trouble sleeping (insomnia).
- Blood clots are a rare but serious side effect of tamoxifen. They most often happen in the calf (lower leg) or lung.
- Signs of a blood clot in the leg can be leg pain, warmth, and swelling of one leg more than the other.
- Signs of a blood clot in the lung can be fever, difficulty breathing that comes on very quickly, racing heart, chest pain (that tends to be worse when you take a deep breath).
- If you have any of these symptoms, call your provider right away or go to the nearest emergency room.
- If you are being treated with GnRH analog medicine (such as Lupron) you should have a baseline bone strength test (called a DEXA scan). This test should be repeated every 2 years. Your team may suggest you get more calcium and vitamin D in your diet or in pill form to help keep your bones strong. Weight-bearing exercises such as walking, dancing, and playing tennis help keep your bones strong.
- If you are taking other hormone therapies, you can learn more on OncoLink.
What about radiology and lab tests?
Routine blood work, CT scans, or bone scans to look for cancer spread (also called metastases) are not recommended. Research has shown that if a person does get metastatic disease, the type of treatment, how they do on treatment, and how long they live is the same, whether or not it is found on a scan or when a person has symptoms. So, providers do not do tests to look for metastatic disease unless you have symptoms.
Healthy living after cancer
- Research has shown that leading an active life and having a healthy weight, with a BMI (body mass index) of 20-25, lessens the chance of cancer coming back.
- Getting regular exercise and eating a healthy diet can help you reach this goal.
- Weight-bearing exercises, such as walking, yoga, and dancing can also be helpful in keeping your bones strong.
- Talk with your healthcare team about how to get started with (or back to) an exercise regimen!
- It is also important to keep your health insurance so that you can get your follow-up care. If you are having insurance issues, ask your team to suggest a social worker who can help with this.
Corti, C., Crimini, E., Criscitiello, C., Trapani, D., & Curigliano, G. (2020). Adjuvant treatment of early male breast cancer. Current Opinion in Oncology, 32(6), 594-602.
Giordano, S. H., Buzdar, A. U., & Hortobagyi, G. N. (2002). Breast cancer in men. Annals of internal medicine, 137(8), 678-687.
Hassett, M. J., Somerfield, M. R., Baker, E. R., Cardoso, F., Kansal, K. J., Kwait, D. C., ... & Giordano, S. H. (2020). Management of male breast cancer: ASCO guideline. Journal of Clinical Oncology, 38(16), 1849-1863.
National Comprehensive Cancer Network (NCCN). (2023). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Breast Cancer Version 4.2023. Taken from https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf
Pemmaraju, N., M. F. Munsell, G. N. Hortobagyi, and S. H. Giordano. "Retrospective review of male breast cancer patients: analysis of tamoxifen-related side-effects." Annals of Oncology 23, no. 6 (2012): 1471-1474.