Monitoring for Recurrence
As your follow-ups become less frequent after treatment, it’s natural to feel like you’re not being watched as closely as before. During this shift, worries about your illness returning—or concerns about developing another cancer—can surface. Hearing others’ stories and not knowing exactly why you got breast cancer can all add to that anxiety. This section explains how recurrence is monitored, when to call your doctor, and ways to cope with these fears.
How often should you be screened for recurrence?
After treatment ends, your follow-up routine naturally changes. You will continue seeing your oncologist for a period of time before transitioning some of your care to a primary care physician (PCP) or a survivorship specialist. The schedule for monitoring a recurrence depends on your age, diagnosis, and the treatments you received.
Below are the general recommendations. Your doctor may adjust this plan based on your individual needs.
If You Were Treated for Stage 0–3, ER-Positive Breast Cancer
You will primarily be followed by your medical oncology team for a period of 5 years or for as long as you remain on endocrine therapy, whichever is longer. Generally, you will be seen every 6-12 months during that time period. After endocrine therapy is complete, routine screening can transition to your PCP or survivorship provider.
Additionally, based on surgical outcomes, you may have 1-2 follow ups with your surgical team and a follow up visit with your radiation team, if applicable.
*For people with DCIS who do not have a medical oncology team, you will likely be followed by your surgical oncology team during this time period.
If You Were Treated for Stage 0–3, ER-Negative Breast Cancer (Including HER2+ and Triple Negative)
You will primarily be followed by your medical oncology team for a period of 5 years. Generally, you will be seen every 6-12 months during that time period. After year five, routine screening can transition to your PCP or survivorship provider.
Additionally, based on surgical outcomes, you may have 1-2 follow ups with your surgical team and a follow up visit with your radiation team, if applicable.
*For people with DCIS who do not have a medical oncology team, you will likely be followed by your surgical oncology team during this time period.
What about imaging?
Your doctor will recommend ongoing breast imaging—including mammograms—based on the amount of breast tissue you have after treatment. This is tailored to your medical history.
What is not recommended?
For routine recurrence screening, the following are not advised:
- Tumor marker blood tests
- CT scans
- PET scans
- Bone scans (not the same as bone density tests)
These tests can lead to unnecessary worry, false alarms, and treatment that does more harm than good. They are reserved for situations when symptoms or physical exam findings indicate they are truly needed.
If recurrence is on your mind, you may have heard about circulating tumor DNA (ctDNA) tests. This video explains what ctDNA is, why researchers are studying it, and why these tests are currently not being used to assess for breast cancer recurrence.
When to Contact Your Doctor
As you move forward after treatment, you may notice aches, pains, or changes that naturally raise questions. Most will have nothing to do with recurrence — but if something doesn’t feel right, trust your instincts and check in with your care team. It’s always better to ask. Reach out if you notice anything new that concerns you or any of the following:
A new breast lump
Rash or swelling in the breast or arm
Nipple discharge
Bone, chest, or abdominal pain
Persistent pain in one specific part of the breast
Trouble breathing or coughing
Ongoing headaches
Unexplained weight loss
Dana-Farber’s Center for Early Detection and Interception
For individuals with an increased risk of developing cancer, this integrated clinical and research program focuses on earlier detection and preventing pre-cancerous conditions from progressing. Care is centered on identifying risk and addressing concerns before disease advances.
