Regular checkups are needed after breast cancer surgery, because there is a higher possibility of recurrence and metastasis within two years after surgery, so the interval of comprehensive review is shorter, and the frequency of review decreases afterwards.
The examination is not complicated, but how often should it be done and what should be checked each time?
How often should I be examined after breast cancer surgery? What should be checked?
Within two years after surgery.
Review every six months.
Each review includes ultrasound of the contralateral breast and armpit, ultrasound of the abdomen, liver, gallbladder, pancreas, spleen and kidneys, ultrasound of the pelvis, uterus and adnexa, and X-ray chest X-ray, including bone scan at six months and one year.
Two to five years after surgery.
Checkups are done once every year.
Each review includes ultrasound of the contralateral breast and bilateral axillae, ultrasound of the abdomen, liver, gallbladder, pancreas, spleen and kidneys, ultrasound of the pelvic uterus and adnexa, X-ray of the chest and bone scan.
After 5 years postoperatively.
Checkups are performed every 1 year.
Each review includes ultrasound of the contralateral breast and axilla, ultrasound of the abdomen, liver, gallbladder, pancreas, spleen and kidneys, ultrasound of the pelvis, uterus and adnexa, and X-ray chest radiograph.
The time of review is counted from the time of surgery, and it does not need to be very strict, and it does not matter if the difference is 1~2 months. That means six months, one year, one and a half years, two years, three years, four years, five years, six years after surgery ……… Regular checkups are required.
It should be reminded that some patients underwent hysterectomy and double adnexal resection, such patients do not need to have pelvic examinations anymore and can inform their doctors in advance.
These examinations are all closely related to breast cancer. If patients have other problems, additional examinations are needed, such as thyroid ultrasound for patients with nodules in the thyroid gland, and liver function test for patients with abnormal liver function during chemotherapy.
Do you check blood after breast cancer surgery?
There are many blood tests, including routine blood test, triple test (liver test, kidney test, lipid test), sex hormone level and tumor markers.
Long-term use of endocrine therapy drugs (such as toremifene, anastrozole, letrozole and exemestane) after surgery may affect the blood count and triple test, and in a few cases, leukopenia, increased transaminases and reduced creatinine clearance may occur, which need to be checked regularly.
Long-term use of toremifene may lead to amenorrhea, especially in female patients aged 45-50 years who are more likely to be amenorrheic after taking the drug. If there is no menstruation for 12 consecutive months, a blood test for sex hormone level is needed to clarify whether menopause is occurring, and after menopause, other endocrine therapy drugs can be used instead.
In addition, when local recurrence and distant metastasis occur, some patients will have a significant increase in the expression level of tumor markers in serum, especially CEA (carcinoembryonic antigen) and CA125 (one of the tumor markers in the serum of breast cancer patients).
Although normal tumor markers cannot completely exclude local recurrence and distant metastasis probability and additional imaging tests are needed, changes in tumor markers are helpful in assessing the disease.