Author: Dr. Nathalie Levasseur
Date of completion: April 2026
Date of next review: May 2027
See Breast Clinical Care Pathway
In addition to the recognized increase in risk of developing a carcinoma of the contralateral breast, patients who have had breast cancer have a statistical increase in their risk of developing sarcoma of the breast/chest wall if treated with radiotherapy, carcinoma of the colon, carcinoma of the endometrium, and carcinoma of the ovary. The family physician should be aware of these possibilities in the follow-up of patients with breast cancer and should ask about corresponding signs or symptoms during the annual history.
If a patient with a history of breast cancer requires contraception options include non-hormonal contraception, such as a barrier technique or an IUD.
Pregnancy after breast cancer diagnosis does not result in any increase in risk of recurrence. The POSITIVE study demonstrated safety in pausing endocrine therapy in HR+ breast cancer for two years to allow for conception, pregnancy, delivery and breast feeding to occur.1
- Partridge A.H., Niman S.M., Ruggeri M., Peccatori F.A., Azim H.A., Colleoni M., et al. Interrupting Endocrine Therapy to Attempt Pregnancy after Breast Cancer. Interrupting Endocrine Therapy to Attempt Pregnancy after Breast Cancer. N. Engl. J. Med. 2023 May 4;388(18):1645-1656. doi: 10.1056/NEJMoa2212856. PMID: 37133584; PMCID: PMC10358451.
- Partridge A.H., Niman S.M., Ruggeri M., Peccatori F.A., Azim H.A., Colleoni M., et al. Interrupting Endocrine Therapy to Attempt Pregnancy after Breast Cancer. Interrupting Endocrine Therapy to Attempt Pregnancy after Breast Cancer. N. Engl. J. Med. 2023 May 4;388(18):1645-1656. doi: 10.1056/NEJMoa2212856. PMID: 37133584; PMCID: PMC10358451.
- Poggio F., Del Mastro L., Bruzzone M., Ceppi M., Razeti M.G., Fregatti P., et al. Safety of systemic hormone replacement therapy in breast cancer survivors: a systematic review and meta-analysis. Breast Cancer Res. Treat. 2022 Jan;191(2):269-275. doi: 10.1007/s10549-021-06436-9. Epub 2021 Nov 3. PMID: 34731351.
Being physically active maintains optimal bone health and decreases the risk of a bone fracture by improving bone mass and increasing muscular strength, coordination and balance and thereby reducing falls. Physical activity that is weight bearing is best, examples include walking, dancing, aerobics, skating and weightlifting.
Smoking is related to poor bone and general health. If you smoke, ask your doctor for assistance to stop smoking.
BC Cancer Smoking Cessation Program
The risk of developing lymphedema is related to the amount of surgery received to the axilla (sentinel lymph node biopsy less risk than axillary lymph node dissection) and the need for adjuvant radiation to the axilla (no radiation = lower risk). There is no increase in risk of lymphedema from blood draws, blood pressure measurement, or lifting of the affected arm. Moreover, increased physical activity has been shown to decrease risk of lymphedema. Prophylactic measures of sleeve use, exercise, and maintenance of a BMI < 30 all help to reduce the risk of lymphedema. Patients MAY USE the affected arm for blood draws and IV access under aseptic techniques without increased risk of lymphedema.
Exercise Support
