Ongoing Care and Follow-Up Appointments

Traditional Follow-Up

Following on from your surgery, you will be seen within two weeks after your operation. We will discuss the results of the operation with you and develop a future follow-up pathway plan with you. The Breast Specialist Nurses will also make arrangements to see you in their breast review clinic annually. Please do not hesitate to contact them via the Breast Secretaries if you have any problems.

You will be discharged from the hospital back to your GP, five years post the date of your surgery.

Surveillance for Breast Cancer Patients

All women who have had breast cancer will have regular follow-up mammograms (unless you have had bilateral mastectomies).

Annual mammograms of both breasts after a wide local excision (lumpectomy).

Annual mammograms of the opposite breast after a mastectomy.

If you are under 50 you will continue to have annual mammograms at the Breast Unit at Salisbury Hospital until you are 50 (at age 50 you will then be entered into the National Breast Screening Programme)
If you are over 50 you will have annual mammograms for 5 years at the Breast Unit at Salisbury Hospital (After 5 years you will be entered into the National Breast Screening Programme, where you will be invited for a mammogram every 3 years)
If, after 5 years of annual mammograms, you are over 70, you will not be routinely invited for a mammogram but can request one every 3 years by contacting your GP or nearest Breast Screening Unit.

How will I receive the results of my mammogram?

We will write to you and your GP with your mammogram results within 2-3 weeks.

What is Supported Self-Management Pathway (SSMP)?

Supported Self-Management Pathway (SSMP) previously known as Patient Initiated Follow-Up (PIFU) is our process of follow-up for patients after treatment for breast cancer.

In this follow-up you will not receive annual follow-up appointments. There is now good evidence to show that following-up patients in this way does not really help. SSMP encourages you to be in control of your breast cancer follow-up and empower you to know what to look out for in the future.

Instead of annual follow-ups, we encourage you to call the SSMP co-ordinator (01722 336262 ext. 2417) who can co-ordinate and communicate with your breast team to answer questions or deal with any concerns if/when they arrive. Depending on the surgery you have had, you will still have annual mammograms under the Breast Unit for 5 years post-surgery.

When entered into this follow-up, you will be provided with an SSMP booklet, information on breast awareness and also invited to a Moving Forward Clinic (please see below).

Breast Moving Forward Clinic

Once entered into this follow-up, you will be invited to a one-off Moving Forward Clinic. This is a two-hour session in the format of a presentation run by members of the Breast Team. This presentation covers medical topics following on from treatment such as: menopausal symptoms, scar management, breast awareness and lymphoedema. We also cover the psycho-social impacts of cancer such as: fatigue management, anxiety management, diet, exercise and support services.

The Moving Forward Clinic is a group session, and you will therefore have the chance to meet with other individuals who have also undergone treatment for breast cancer and who are also in SSMP.

Due to the current circumstances surrounding the Coronavirus, it is not safe to currently run this clinic. However in the meantime, you can access this clinic virtually. Please contact the SSMP co-ordinator, who will provide you with a link for this.

Late Side Effects from breast cancer treatment

Pain and discomfort (breast, chest wall, shoulder, joint pain)

Causes of pain include:

- Postoperative pain
- Nerve pain
- Lymphoedema
- Medication (joint pain)

Scars and effects of surgery/radiotherapy
- Scar can take up to 2 years to mature to thin white lines
- Scars can be red, slightly raised and lumpy
- Occasionally scars become stretched and overgrown

Menopausal symptoms (hot flushes, fatigue, mood swings, joint aches, weight gain, thinning of hair and nails, sleep disturbances, vaginal dryness)
- Chemotherapy may induce an early menopause
- Hormone treatment reduces the circulation of oestrogen resulting in the menopausal symptoms

Lymphoedema
- Axillary surgery (Sentinel lymph node biopsy or axillary clearance) may be removed in breast surgery
- Lymph drainage routes are then altered or reduced resulting in a lymph fluid build up
- This results in swelling, tightness or discomfort

When should you contact The Breast Team?

You should arrange a review through your SSMP co-ordinator if you have concerns about any of the following issues:

New changes to your breast, chest wall region, neck or under your arm
A change in size or shape of your breast
A new lump or thickening that feels different from the rest of the breast tissue
A change in skin texture such as puckering or dimpling (resembling orange peel)
Redness or a rash on the skin and/or around the nipple (which may look like eczema)
Your nipple becoming inverted (pulled in) or changing its position or shape
Discharge (liquid) from one of both or your nipples
A swelling in your armpit or around your collarbone
Constant pain in your breast or armpit
Your ongoing Hormonal Therapy and potential menopausal symptoms
Possible side effects from your chemotherapy and/or radiotherapy treatment
Problems related to your original breast surgery or questions about breast reconstruction
New medical symptoms that you are worried could represent a spread of your breast cancer (please see below)
If you would like to access any additional holistic support and/or information on living a healthy lifestyle, please follow the page to Breast Cancer Support.

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