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NCCN Guidelines for Patients


Breast Cancer - Early-Stage


, Version 1.2016


Follow-up care

Care for side effects

Care for side effects

Adherence check

If you take endocrine therapy, it is very important that

you don’t stop taking your medication. If you do, the

cancer will be more likely to return. Tell your doctor

about any side effects that make you think about

quitting. There may be ways to get relief.

GYN exam

If you take tamoxifen, a GYN (


ecologic) exam is

needed each year since this drug can increase your

chances for cancer of the uterus. For this exam, your

doctor will ask about any abnormal bleeding. If you

have seen any vaginal bleeding that isn’t normal for

you, tell your doctor.

Bone mineral density

If you take an aromatase inhibitor, you should

have your bone mineral density tested regularly.

Your bone mineral density should also be tested if

cancer treatments caused you to start menopause.

Aromatase inhibitors and starting menopause early

can cause bone loss. Bone mineral density tests

show your doctors how strong your bones are. These

tests use x-rays.


Lymphedema is swelling due to buildup of lymph fluid.

It occurs in the arms after lymph node removal. It can

happen just after surgery or months to years later

if ever. Thus, it’s important to know about this side

effect so you won’t be caught off-guard. If you have

lymphedema, your doctor will assess it at follow-

up visits and refer you to an expert in lymphedema

management. You may be able to reduce the swelling

by exercise, massage, and other means.