Information Following Treatment for Patients with Early Breast Cancer. Bradford Teaching Hospitals. NHS Foundation Trust

Transcription

1 Iformatio Followig Treatmet for Patiets with Early Breast Cacer Bradford Teachig Hospitals NHS Foudatio Trust

2 What happes ext? You have ow completed your iitial treatmet to remove your breast cacer. There are a umber of approaches to follow up after breast cacer treatmet ad these do sometimes vary betwee differet patiets ad hospitals to meet your idividual eeds. The most importat thig for you to remember is if you have ay problems or become worried, there is a team of professioals icludig your breast care urse, GP ad hospital specialists who ca help you. What is the purpose of follow up care? It provides you with a opportuity to raise cocers ad ask questios. It allows health care staff to moitor your recovery, aswer questios, record the outcome of your treatmet ad moitor ay ogoig treatmet you are takig. It may help i plaig your future care. If you have agreed to take part i a cliical trial it allows the research team to assess your recovery. 1

3 What checks will be made? There are two mai purposes of hospital follow-up: Cliical breast examiatio If you atted a hospital cliic your doctor or urse will look at your breasts for chages i size or shape. They will the feel each breast / mastectomy scar (chest wall) ad the area uder both arms for chages i texture (thickeig i the ski) or the presece of lumps. Although cliical examiatio is routiely performed, it is uusual for ay lumps to be detected that you were uable to feel yourself. The cliics are ru by a team of breast surgeos. You may be see by a doctor or a breast care urse qualified to work i the cliic. You will be see i the post treatmet cliic aroud six moths, oe year ad two years. If you are receivig the drug Tamoxife you may also be see after five years of treatmet to check your meopausal status ad discuss your ogoig treatmet optios. After this time, routie cliic appoitmets will ed, but you ca still cotact us o the umbers detailed at the ed of this booklet. Mammography A mammogram is a breast X-ray. Moder mammography equipmet exposes the breast to extremely low levels of radiatio. The use of mammograms ca detect early chages withi the breast which may be associated with breast cacer. 2

4 Mammography cotiued Uless you have had a bilateral mastectomy (surgery to remove both breasts) you will be ivited to have a mammogram o a regular basis. If you have had a mastectomy or mastectomy ad recostructio of the breast you will be ivited for a mammogram of the other breast every year for 10 years or util you eter the NHS Breast Screeig Programme whichever is later. Thereafter it is appropriate for you to cotiue routie mammograms oce every three years withi the NHS Breast Screeig Programme. If you have had a lumpectomy (wide local excisio) you will be offered a mammogram of each breast every year for 10 years or util you eter the NHS Breast Screeig Programme, whichever is later. Thereafter it is appropriate for you to cotiue routie mammograms oce every three years withi the NHS Breast Screeig Programme. Mammogram appoitmets will be set to you by post. Whilst you are attedig for ay yearly mammograms you should cacel ay ivitatios set by the Natioal Breast Screeig Programme. You should receive the results of your mammogram by post withi 4 weeks of your appoitmet. If you do ot receive your results you ca phoe the breast care urses, o the umber at the ed of this booklet. 3

5 NHS Breast Screeig Programme I December 2007, the Departmet of Health s Cacer Reform Strategy aouced that from 2012 the NHS Breast Screeig Programme would be exteded to cover wome betwee the ages of 47 ad 73. I most parts of the coutry the NHS Breast Screeig Programme will ivite doctors practices for screeig i tur. So you will ot ecessarily get your ivitatio i the year that you tur 47. As log as you are registered with a doctor, you will be ivited for breast screeig before your 50th birthday. The ivitatios will cotiue at three yearly itervals util the age of 73. After this time you ca request further appoitmets directly from the Screeig Departmet but you will o loger receive a ivitatio from them. How effective are follow-up checks? The radiologist (a doctor who specialises i the X-rays) will look at your mammogram(s) for ay abormalities. Rarely other tests to look at the breasts may be required. This does ot mea that your cacer has retured. If you eed further images or tests you will be asked to retur to the hospital where you will meet a cosultat X-ray specialist who will explai why you have bee asked to re-atted ad will explai ay tests required. Quite commoly the abormality is othig to worry about ad you will be reassured followig further tests. If you are ivited back to the departmet you ca cotact your breast care urse for further support ad advice o the umber at the back of this booklet. 4

6 Please be aware that mammograms are ever 100% accurate ad if you have a ew breast symptom, particularly a lump, you should still cotact us via your breast care urse who will arrage cliic appoitmets as ecessary. If you are o loger havig regular appoitmets at the hospital with the breast surgeo you may eed a referral from your GP. If this is required the breast care urse will be able to advise you. What check-ups are ot part of follow up? Other scas, X-rays ad blood tests are ot required as part of your routie follow up. Your breast care urse, GP or hospital specialist will advise you if you eed further ivestigatios. What to look for? Followig treatmet may wome live to a old age without cacer related problems. You will get ormal coughs ad colds, aches ad pais. You may also experiece some effects from the treatmet you have received, for example: Followig surgery ad radiotherapy Pais i the treated area Rib tederess Ski chages Uder arm umbess 5

7 Decreased shoulder movemet it is importat to discuss this with your breast care urse who ca refer for physiotherapy support if this is appropriate. Breast swellig if you had a lumpectomy You may have some chage to the size ad shape of the breast particularly aroud the scar. If the breast becomes smaller you ca cotact the breast care urse for cosideratio of fittig of a partial prosthesis (also called a shell) to help you regai equal shape i a bra. Followig Chemotherapy, Hercepti ad ati-hormoal therapy Fatigue This ca be improved by exercise activity please ask your breast care urse for advice. Some chemotherapy treatmet may lead to discolouratio of the ails ad brittle ails this will improve oce your chemotherapy stops. Early meopause with symptoms icludig hot flushes, ight sweats, palpitatios (rapid heartbeat), mood chages, joit aches ad pais, vagial dryess. If you eed help with these symptoms you ca talk to your breast care urse or hospital doctor. If you are havig the drug Hercepti you will have regular moitorig of your heart ad your ocologist will talk to you about the timig of these scas ad whe your results will be available. 6

8 Some ati-hormoal drugs affect the boe stregth. If this is a side-effect of your treatmet you will be iformed. Your surgeo or ocologist will arrage a special sca to look at the thickess of the boes before treatmet (a DEXA sca) ad we will write to you with the results of this ad provide detailed recommedatios to maitai your boe health durig the time you are takig treatmet. If you are takig Tamoxife or Hercepti it is recommeded you do ot get pregat whilst takig this treatmet. Your breast care urse or your hospital doctor ad GP ca provide further help ad advice about suitable cotraceptio. Remember you ca ask for help For some people the side effects are a costat remider of their breast cacer. For others, experiecig ogoig effects of treatmet leaves them feelig very low ad they may struggle to cope. If you eed extra support please talk to your breast care urse or your GP. Some symptoms may cause you axiety or cocer. May will be othig to worry about but if you experiece ay of the symptoms below you should brig them to the attetio of your hospital doctor or breast care urse: Ay pai lastig more tha 3 4 weeks New chages i the breast(s) Uexplaied lumps or bumps aywhere i the body 7

9 Persistet back pai or pai i the boes which wakes you up at ight Pai that requires cotiual paikillers Breathlessess or a persistet dry cough Uexplaied weight loss Uexpected vagial bleedig Swellig of the arm (lymphoedema) If you experiece these symptoms it does ot ecessarily mea your cacer has retured. It does however mea that you should speak to your breast care urse for advice or be assessed by your GP. What happes whe you are discharged from cliic? Routie cliic visits are ow o loger ecessary. Please remember, however, that you ca cotact us o the umbers o the back page of this leaflet if you have ay breastrelated problems. The most importat thig is that if you have ay problems or you become worried, there is a team of professioals icludig your breast care urse, GP or hospital specialists who ca help. 8

10 Treatmet Summary Name... Hospital umber... Surgical... Medical (chemotherapy ad Hercepti treatmet dates) Radiotherapy... Ati-hormoe drugs start ad plaed timig of treatmet Mammogram start... Mammogram fiish... Cliical trials record... 9

11 Cotact umbers 1) Breast Care Nurse aswer machie Moday to Thursday (9am 5pm) Friday (9am 4pm) Telephoe: If you phoe please leave your ame, date of birth ad a cotact telephoe umber. This machie is checked regularly. It may ot always be possible to retur your call o the same day. 2) Prosthetic advice ad appoitmets Cliics are ru from The Dales Uit, Level 2, Area 8, Horto Wig, St Luke s Hospital o a Moday ad Thursday morigs. Telephoe: to make a appoitmet. 3) Breast Secretaries Telephoe: ) Breast Research Nurse Mrs Hele Robertshaw Telephoe:

12 Smokig Bradford Teachig Hospitals NHS Foudatio Trust is a smoke-free orgaisatio. You are ot permitted to smoke i ay of the hospital buildigs or grouds, with the exceptio of the smokig shelters which are provided for visitors ad patiets oly. Textphoe We use Next Geeratio Text for people with hearig difficulties. This used to be called BT Text Relay. Breast Care Nurses Breast Secretaries / / Prosthetic Appoitmets Research Nurse If you eed this iformatio i aother format or laguage, please ask a member of staff to arrage this for you. MID Ref / Authors: M. Blackbur ad C. Tait Publicatio date: May 2017 / Review date: May 2019