Breast cancer survival rates have come a long way in recent years. Thanks to better detection and treatment, more than 80% of women with early-stage breast cancer live at least 10 years. About 8 million people worldwide are living after a breast cancer diagnosis.
Many doctors will consider you “cancer-free” if all of your signs and symptoms of cancer are gone after five years.
But even if you’ve beat breast cancer, you’re likely to face physical and emotional challenges after treatment. Researchers at the 2025 American Society of Clinical Oncology (ASCO) Meeting offered insights on how breast cancer survivors can tackle these issues head-on and thrive after treatment.
Digital Health Solutions for Follow-up Care
Survivorship care is an area of breast cancer treatment that needs improvement, according to speaker Ines Luis, MD, PhD, from Gustave Roussy. "I think we would all agree that we do need a shift toward a comprehensive, team-based, data-driven, proactive survivorship care," she said.
In her presentation, Luis outlined what she sees as the main problems with the current survivor follow-up care models:
- They are “oncology-driven” and tend to focus solely on tracking cancer recurrence.
- There’s a lack of coordination between supportive care specialists and other doctors.
- There’s not enough supportive care.
- There’s a lack of personalization.
Luis proposed that digital tools could solve some of these issues. Several models are in development that use remote monitoring and artificial intelligence (AI) to improve follow-up care. Luis said that these sorts of digital health tools could offer better individualized care for patients.
The digital tools may also provide remote monitoring and improve communication between different health specialists. Additionally, they could boost patient empowerment, self-management, and supportive care delivery, Luis said.
She provided an example of the Young and Strong Program for Young Adults with Breast Cancer at Dana-Farber Cancer Institute. This resource is used to educate patients on symptom management and survivorship issues.
Though digital tools appear to be a promising resource, Luis said there are some obstacles. For one, they need to be available in all languages and accessible for diverse populations. She also stressed that more research needs to be done to prove that these digital tools can be effective.
“There is an urgent need to accelerate research, but also to improve the robustness and scalability of the digital health infrastructures that are serving us to ensure a large-scale, sustainable impact on survivorship care delivery,” she said.
Alleviating Gynecologic Symptoms
Breast cancer survivors often have gynecologic symptoms. Speaker Wolfgang Janni, MD, PhD, from University Hospital Ulm, discussed some common issues and what emerging research suggests are the best ways to treat them.
Hot flashes
“Almost every patient complains at some point of time about hot flashes,” Janni said. He went on to describe possible remedies:
Cognitive behavioral therapy (CBT). This is a type of talk therapy. Research suggests it can help you work through negative thoughts and feelings, so you can manage hot flashes better.
Exercise. Regular physical activity can help lessen the frequency of hot flashes over time.
Medicines. Examples include gabapentin, melatonin, venlafaxine, and newer drugs, like fezolinetant.
Genitourinary Syndrome
Many breast cancer survivors have genitourinary syndrome of menopause (GSM), which is due to low estrogen. Symptoms include vaginal dryness, pain during sex, and frequent urinary infections.
In his presentation, Janni said that research shows these treatments can help GSM:
- CBT
- Exercise
- Pelvic floor exercises
- Vaginal moisturizers
Fatigue
Studies show about 1 in 4 breast cancer survivors have severe fatigue, even 10 years after a diagnosis. Janni discussed these treatments that could help:
- CBT
- Exercise
- Mindfulness-based programs
Musculoskeletal pain
Muscle and joint pain are common complaints among breast cancer survivors, especially those who take aromatase inhibitors (medicines that lower estrogen). Janni said exercise or the medicine duloxetine may help relieve this unpleasant side effect.
Bone health
“Bone health is a huge issue in our elderly patients, especially,” Janni said. He discussed international guidelines that suggest postmenopausal patients take medicines called bisphosphonates to prevent osteoporosis later on.
Possible Complications After Primary Breast Reconstruction
Research suggests about 38% of women who have a mastectomy will have breast reconstruction surgery. In her presentation, Jessica Erdmann-Sager, MD, from Brigham and Women's Hospital, discussed research on the complications that patients face after reconstruction procedures.
She talked about the different types of breast reconstruction:
Implant reconstruction (alloplastic). An implant is placed under your skin and either above or below the chest muscle to create the shape of a breast. Sometimes, a device called a tissue expander is first used to stretch the skin. Erdmann-Sager said this was the most common type.
Flap reconstruction (autologous). Tissue from another part of your body, like your belly, back, or thigh, is used to make a new breast.
According to database sources, infection is the most common reason for hospital readmission for both types of reconstruction procedures. About 32% of patients also report chronic pain, regardless of what type of procedure they had, Erdmann-Sager reported.
Other issues depend on the type of reconstruction but may overlap, per Erdermann-Sager.
Some complications of implant reconstruction are:
- Bleeding
- Fluid collection
- Problems with wound healing
- Mastectomy flap necrosis (the flap doesn’t get enough blood and starts to die)
- Venous thromboembolism (a blood clot forms in your vein)
- Scar tissue
- An implant rupture or leak
- Deformities or changes in breast shape
- Rare cancers that are found around breast implants
- Breast implant illness (a group of symptoms that may be caused by breast implants)
Some risks linked to flap reconstruction include:
- Blood clots or venous thromboembolism
- Flap loss
- Wound healing issues
- Mastectomy flap necrosis
- Fat necrosis (death of fat cells)
- Fluid collection
- Hernia
- Numbness in your abdomen
- Size dissatisfaction (due to weight changes)
“Complications are specific to the type of reconstruction as well as the plane of the breast prosthetic placement. Everything in breast reconstruction is a mix of advantages and disadvantages that need to be weighed on an individual patient basis,” Erdmann-Sager concluded.
How to Manage Lymphedema
Lymphedema is swelling due to problems with the lymphatic system. It can happen if cancer blocks lymph vessels. Or it can happen after cancer treatment if your body’s drainage system is damaged or blocked.
Cristina Kline-Quiroz, DO, from Vanderbilt University Medical Center, talked about how to manage this condition in breast cancer survivors. She said identifying the signs early is a vital first step.
“I am very passionate about surveillance and prevention because this is a key opportunity to prevent the development of a chronic condition that requires lifelong management,” she said.
Kline-Quiroz said that, at her clinic, they carefully monitor patients’ measurements at certain times:
- Before treatment
- Every three months for the first three years after treatment
- Every six months in year four and five after treatment.
“If at any point during surveillance, they develop clinically visible lymphedema, then we’re getting them into lymphedema therapy,” Kline-Quiroz said.
Treatments for lymphedema include:
- Wearing compression garments
- Compression devices
- Manual lymph drainage (a type of gentle massage)
- Exercise
- Elevation
- Education
Takeaways
Even as a survivor, breast cancer can still affect your daily life. Many survivors face an array of challenges. It’s important to follow up with your oncologist and care team to help manage any unwanted symptoms.
Show Sources
Photo Credit: DigitalVision Vectors/Getty Images
SOURCES:
American Society for Clinical Oncology (ASCO) Educational Book: “Long-Term Follow-Up Care After Treatment for Primary Breast Cancer: Strategies and Considerations.”
National Cancer Institute (NCI): “Understanding Cancer Prognosis.”
2025 ASCO Meeting: “Follow-Up Care After Treatment for Primary Breast Cancer.”
Johns Hopkins Medicine: “Genitourinary Syndrome of Menopause.”
Cancers: “Fatigue among Long-Term Breast Cancer Survivors: A Controlled Cross-Sectional Study.”
Annals of Surgical Oncology: “National Trends in ‘Going Flat’ After Mastectomy.”
Mayo Clinic: “Lymphedema.”
American Society of Plastic Surgeons: “Where will your breast implants be placed?”
