FOLLOW-UP ACTIVITIES | RECOMMENDATIONS FOR EXAMINATION |
---|---|
Medical history | Bone pain |
Dyspnea | |
Weight loss | |
Abdominal symptoms | |
New nodules or masses | |
Vaginal bleeding if taking tamoxifen* | |
Physical examination | Breast and chest wall |
Axilla | |
Supraclavicular nodes | |
Arm lymphedema | |
Hepatomegaly | |
Ascites | |
Leg swelling if taking tamoxifen† | |
Mammograms | Annually |
Routine laboratory and radiological tests | As clinically indicated by signs or symptoms |
Bone mineral density scans for women at risk of osteoporosis or starting aromatase inhibitors | At completion of adjuvant chemotherapy and before initiation of aromatase inhibitors |
Repeat in 12-18 mo | |
Advise lifestyle modification (reduce alcohol and caffeine intake, stop smoking, increase weight-bearing exercise, take calcium and vitamin D supplements) | |
Consequences of disease or treatment | Menopausal symptoms |
Cognitive functioning | |
Fatigue | |
Weight gain | |
Sexual functioning | |
Fertility | |
Arthralgias | |
Lymphedema | |
Psychosocial distress |
↵* If vaginal bleeding is present in patients taking tamoxifen, a trans-vaginal ultrasound is recommended. Refer to a gynecologist if the endometrial thickness is > 10 mm or if there is persistent bleeding with thickness > 5 mm.
↵† If a patient experiences a thrombotic event while taking tamoxifen, a referral back to the oncologist is recommended.