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Breast cancer


Managing side effects


It will take time to recover from the physical and emotional changes caused by your treatment. Side effects can vary – some people will experience just a few, while others will have more.

Your guide to best cancer care

A lot can happen in a hurry when you’re diagnosed with cancer. The guide to best cancer care for breast cancer can help you make sense of what should happen. It will help you with what questions to ask your health professionals to make sure you receive the best care at every step.

Read the guide

Common side effects

Lymphoedema

Lymphoedema is the swelling (oedema) that develops when lymph fluid builds up in the tissues of part of the body, such as an arm or breast. Some breast cancer treatments may cause lymphoedema, including surgery to remove lymph nodes and radiation therapy to the armpit. People who have had surgery followed by radiation therapy to the armpit are more at risk of lymphoedema.

Lymphoedema can affect people at any time – during active treatment or months or even years afterward, however many people who are at risk never develop lymphoedema. Signs to look for include:

  • swelling of part of your arm or your whole arm
  • a feeling of tightness, heaviness or fullness in the fingers, wrist or the whole arm
  • aching in the affected area.

Some people experience pain, redness or fever, which can be caused by an infection called cellulitis in the area with lymphoedema. If you have any of these symptoms, see your doctor as soon as possible.

Cording

Cording (axillary web syndrome) can happen weeks or months after any type of breast surgery. It is caused by hardened lymph vessels and feels like a tight cord running from your armpit down the inner arm, sometimes to the palm of your hand. You may see and feel raised cordlike structures across your arm, chest or breast which may limit how you move.

Doing gentle stretching exercises the first weeks after surgery can help, or try massage, physiotherapy, or low-level laser treatment by a lymphoedema practitioner. Cording usually improves over a few months.

Nerve pain

Mastectomy, sentinel lymph node biopsy and axillary lymph node dissection can cause nerve pain in the arm or armpit, and mastectomy can cause nerve pain in the chest wall. This may feel like pins and needles, tingling or stabbing pain. It usually settles within a few weeks.

Certain chemotherapy drugs can damage nerves in the hands and feet. This is called peripheral neuropathy or chemotherapy-induced peripheral neuropathy (CIPN), and it can cause weakness, numbness, pins and needles and, occasionally, burning or shooting pain. These symptoms are usually temporary and start to get better over a matter of months, but they can be permanent.

Your doctor will help you manage pain from any permanent or ongoing nerve damage. A psychologist or counsellor, physiotherapist and occupational therapist can also help you improve or manage symptoms.

Thinking and memory changes

Some people with breast cancer notice changes in how they think and remember information. The exact cause is unknown, but studies suggest these changes may be caused by the cancer, emotions such as anxiety and depression, cancer treatments and side effects, and anaesthetic given for surgery.

For most people, thinking and memory problems get better within the first year of finishing treatment. Others may have long-term effects. Speak to your health care team about the services available at your hospital or from a psychologist.

Breast prostheses

A breast prosthesis is a synthetic breast or part of a breast that is worn in a bra or attached to the body with adhesive. It helps give the appearance of a real breast and can be used after breast surgery.

  • Temporary prosthesis – in the first month or two after surgery, you may choose to wear a temporary light breast prosthesis called a soft form. This will be more comfortable next to the scar. Speak to your breast care nurse about ordering a free bra and soft form through Breast Cancer Network Australia.
  • Permanent prosthesis – when you have recovered from treatment, you can be fitted for a permanent breast prosthesis. A permanent breast prosthesis is mostly made from silicone gel and has the shape, feel and weight of a natural breast. It is recommended that you see a trained fitter who can help you choose the right prosthesis. Call 13 11 20 or ask your breast care nurse to find a fitter near you.

Hair loss, wigs and headwear

If you lose your hair during chemotherapy, you may choose to wear a wig, scarf, turban or hat while it’s growing back. You could try out a few options over time and see what feels right for you. You can buy or borrow a wig – some hospitals and treatment centres provide wigs for free or a small fee. You might feel comfortable leaving your head bare.

Call us on 13 11 20 to learn about our wig service or ask your treatment team about borrowing or buying wigs. Check with your private health fund, as some may cover part of the cost of a wig.

Feelings of loss and change

It’s common to feel emotional after a cancer diagnosis. You may feel a sense of grief or loss – of your health and wellbeing, your femininity, your dreams or freedoms, even what you can wear.

Grief can feel like waves of sadness or being teary, and usually settles over time. The busyness of cancer treatment may mean you don’t feel grief until it’s over. If you're concerned, call our compassionate cancer nurses on 13 11 20. It's free and confidential. 

More about emotions and cancer

Changes to body image and sexuality

Breast cancer can affect how you feel about yourself (self-esteem) and make you feel self-conscious. You may feel less confident about who you are and what you can do. You may feel that how you express yourself sexually and your sexual feelings for others have changed.

Give yourself time to adapt. Try to see yourself as a whole person (body, mind and personality) instead of focusing on the parts that have changed. Talking to your partner and learning to get undressed naturally in front of them may also help.

Breast and areola appearance

You may find that having a breast reconstruction or wearing a breast prosthesis improves your self-confidence. Or you may prefer to not have a reconstruction and 'go flat'.

Areola tattooing can tattoo the look of an areola and nipple onto the breast following a mastectomy. Areola tattoos are typically done on breasts with implants, with and without nipple reconstruction. Or you may choose a decorative tattoo to cover scars. For some people this is a way to take control of their body and express themselves.

Low libido

Breast cancer can reduce your desire for sex (libido). You may miss the pleasure you felt from the breast or nipple being stroked or kissed during sex. This may be the case even if you have a reconstruction. If breast stimulation was important for arousal before surgery, you may need to explore other ways of becoming aroused.

Vaginal dryness

Some treatments for breast cancer can cause vaginal dryness, which can make penetrative sex painful. For most people, sex is more than arousal, intercourse and orgasms. It involves feelings of intimacy and acceptance, as well as being able to give and receive love. Although penetration may not always be possible, closeness and sharing can still be part of your relationship.

After treatment you shouldn’t use any hormone-based contraceptives ('the pill' or hormone implants or injections). It is best to use condoms, diaphragms or intrauterine contraceptive devices (IUDs).

 

Menopause and infertility

Chemotherapy can cause your periods to stop for a time or permanently (early menopause). Symptoms of menopause include:

  • hot flushes
  • trouble sleeping
  • vaginal dryness
  • reduced sex drive (libido)
  • tiredness
  • dry skin
  • mood swings
  • weight gain
  • osteoporosis.

Talk to your doctor or breast care nurse about how to relieve symptoms. If chemotherapy causes menopause, you won’t be able to have children naturally. Talk to your doctor before treatment starts, as there may be ways to reduce the risk of early menopause or to preserve your fertility.

If you find out you might not be able to get pregnant and have a child, you may feel a great sense of loss. Talking to a counsellor or someone in a similar situation may help – call 13 11 20 for information about counselling services and support groups in your area.

Looking after yourself

Eating well

Healthy food can help you cope with treatment and side effects and maintain a healthy weight. Many people gain weight during and after breast cancer treatment, which studies show increases the risk of cancer coming back.

Drinking alcohol also increases your risk of breast cancer. If you choose to drink, the recommended guidelines are no more than 10 standard drinks a week and no more than 4 drinks in one day. A dietitian can explain how to manage any special dietary needs or eating problems and choose the best foods for your situation.

Learn more

 

Staying active

You may think it’s important to rest during treatment and recovery, but research shows that exercise benefits most people. Being active can help manage side effects such as tiredness, improve circulation, lift mood, and speed up recovery. Exercise also helps avoid the weight gain that is associated with breast cancer treatments.

There is strong evidence that exercise can reduce the risk of breast cancer returning. The right exercise for you depends on what you are used to, how you feel and your doctor’s advice. For help developing an exercise program, see an accredited exercise physiologist or physiotherapist.

Learn more

Complementary therapies

Complementary therapies are practices that can be used alongside conventional medicines and may help you cope with the physical and emotional impact of cancer, as well as the side effects caused by conventional cancer treatments. Examples include mind-body practices such as mindfulness and meditation, as well as therapies using herbs and plants such as Chinese herbal medicine. 

Learn more

Life after treatment

After your treatment ends, you will have regular appointments to monitor your ongoing health. Your doctors will see how you are going on hormone therapy (if this is part of your ongoing treatment), help you to manage any long-term side effects, and check that the cancer hasn’t come back or spread. 

Between follow-up appointments, let your doctor know immediately of any symptoms you notice or health problems.

What do check-ups involve?

Check-ups after breast cancer treatment are likely to happen every 3–6 months for two years. They will become less frequent after that if you have no further problems.

During these check-ups, you will usually have a physical examination. You will also be able to discuss how you’re feeling and mention any concerns you may have.

You are likely to have a mammogram and, if needed, an ultrasound every year. You won’t need a mammogram if you’ve had a double mastectomy. If there is a concern the cancer may have come back, you may have a bone scan and a CT, PET or MRI scan.

After five years with no sign of cancer, women aged between 50 and 74 can continue to have a free mammogram through the national breast cancer screening program.

What if the cancer returns?

For some people, breast cancer does come back after treatment (recurrence). This is why regular check-ups are important.

In most cases, early breast cancer will not come back after treatment. Although the risk is higher with locally advanced breast cancer, most people will not experience a recurrence.

There are some things that increase the risk of cancer coming back, including:

  • if the cancer was large or the grade was high when first diagnosed
  • if the cancer was found in the lymph nodes
  • if the surgical margin was not clear
  • if the cancer was hormone receptor negative
  • if adjuvant therapy was recommended after surgery but was not started or completed.

These things don’t mean the cancer will definitely come back or spread.

Regularly looking at and feeling your breasts to know what’s normal is important. If you have had a double mastectomy with or without a reconstruction, you should also regularly look at and feel your new shape and get to know your 'new normal'. Tell your specialist, breast care nurse or GP if you notice any changes.

Breast cancer can also return in other parts of the body. Most symptoms will not be a recurrence, but if you have new or ongoing pain, a persistent cough or have lost weight without trying, let your doctor know that you have had breast cancer.

It’s important to continue taking medicines your doctor tells you to, even months or years after your treatment. Talk to them before you stop taking anything, as it may be helping to stop the cancer returning.



Understanding Breast Cancer

Download our Understanding Breast Cancer booklet to learn more

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Expert content reviewers:

A/Prof Elisabeth Elder, Specialist Breast Surgeon, Westmead Breast Cancer Institute and The University of Sydney, NSW; Collette Butler, Clinical Nurse Consultant and McGrath Breast Care Nurse, Cancer Support Centre, Launceston, TAS; Tania Cercone, Consumer; Kate Cox, 13 11 20 Consultant, Cancer Council SA; Dr Marcus Dreosti, Radiation Oncologist and Medical Director, GenesisCare, SA; Dr Susan Fraser, Breast Physician, Cairns Hospital and Marlin Coast Surgery Cairns, QLD; Dr Hilda High, Genetic Oncologist, Sydney Cancer Genetics, NSW; Prof David W Kissane AC, Chair of Palliative Medicine Research, The University of Notre Dame Australia, and St Vincent’s Hospital Sydney, NSW; Prof Sherene Loi, Medical Oncologist, Peter MacCallum Cancer Centre, VIC; Dr W Kevin Patterson, Medical Oncologist, Adelaide Oncology and Haematology, SA; Angela Thomas, Consumer; Iwa Yeung, Physiotherapist, Princess Alexandra Hospital, QLD.

Page last updated:

The information on this webpage has been adapted from Understanding Breast Cancer - A guide for people with cancer, their families and friends (2022 edition). This webpage was last updated in July 2022.

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