After your treatment has ended, you may have regular check-ups (which will include a physical examination) and mammograms. These check-ups will usually be once a year, but may be more frequent at first. You may also need to see your specialist or GP every few months if you are having ongoing treatment with hormonal therapy, or if you have any side effects following surgery, radiotherapy or chemotherapy treatment. If you have had a mastectomy, the breast prosthesis fitter will also be at your first appointment.

The appointments are a good opportunity to discuss with your doctor any worries or problems you may have. However, if you notice any new symptoms or are anxious about anything else between your appointments, you can contact your doctor or nurse for advice. Many people find that they get very anxious for a while before the appointments. This is natural and it may help to get support from family, friends or a support organisation during this time.

Our section on life after cancer gives useful advice on how to keep healthy and adjust to life once treatment has ended.

Women who have had breast cancer are usually advised not to take hormone replacement therapy. This is because there is a risk that the oestrogen it contains can increase the chance of the cancer coming back.

However, if you have troublesome menopausal symptoms, medicines can be used to treat them. If the menopausal symptoms continue despite the medicines, your doctor can prescribe a short course of low-dose progesterone to deal with these. It is important that your progress is very carefully monitored if you take HRT.

Pregnancy

Research suggests that becoming pregnant after treatment for breast cancer does not make the breast cancer more likely to come back.

If you want to have a child, it's important for you and your partner to discuss this with your breast cancer specialist, who knows your full medical history and can talk over the risks and implications. It's usually advisable to wait a while after your initial treatment has finished before trying to become pregnant. The longer you are free of the cancer, the less likely it is to come back. However it is very important to carefully consider what might happen if, after having a baby or while pregnant, the cancer did come back, and whether you want to take that risk.

Infertility

Unfortunately, women who have had radiotherapy to their ovaries or an operation to remove their ovaries will not be able to have children. Sometimes chemotherapy can also cause infertility by bringing on an early menopause. Generally, the older a woman is when having chemotherapy the more likely she is to be infertile afterwards.

Becoming infertile can be very hard for some women to live with – whether or not they already have children. Fertility is a very important part of many people’s lives, and not being able to have children can seem especially hard when you already have to cope with cancer. Some people find it helpful to talk through their feelings about this distressing situation. You can speak to a counsellor by contacting the Cancer Counselling Trust.

Egg or embryo storage

If your treatment is likely to make you infertile, and you would like to have children in the future, it is sometimes possible to remove eggs from the ovaries, fertilise them and store the embryos to use later. It is also sometimes possible to store unfertilised eggs, although this is very experimental. Eggs need to be removed before you start treatment.

At a later date the fertilised eggs can be thawed and implanted into the womb to start a pregnancy. These techniques may allow some women with breast cancer, who had become infertile due to treatment, to have children in the future. If you want to have children it's very important to discuss this with your doctor before treatment begins. Your doctor can refer you to a fertility specialist for advice on the possible options available to you.

Women who have had breast cancer are usually advised not to take the pill. This is because there is a risk that the hormones (oestrogen and progesterone) in the contraceptive pill may stimulate the growth of breast cancer cells. Your cancer specialist or GP can give you advice on contraception.

Choice of contraception

Barrier methods of contraception such as condoms or the cap are the most suitable. Lubricating jelly (available without prescription from the chemist) is completely safe to use with barrier contraceptives if extra moisture is needed during sex. Your GP can also fit you for a cap if this is the method of contraception you choose. Coils (IUDs) can be an effective alternative method of contraception and your GP can fit you with one. Some women choose to be sterilised to prevent the risk of pregnancy.

The choice of an effective contraceptive is a very personal one. Your likes and dislikes, and those of your partner, are obviously important. Some women may also choose to take into account religious and moral considerations. Unfortunately, the withdrawal and rhythm methods of contraception are not safe enough to be effective as protection against pregnancy. Some women find that, if necessary, talking through their situation with their religious leader, the Family Planning Association (FPA) or a trained counsellor helps them to find acceptable alternatives.

If the lymph nodes in your armpit have been removed by surgery, or you have had radiotherapy to the armpit, there is a risk of lymphoedema (swelling of the arm or hand). This is usually mild, and develops gradually a few months or several years after treatment. Lymphoedema is more likely if you have had both surgery and radiotherapy to the underarm.

Sometimes swelling of the arm may occur after the initial surgery, but this usually goes back to normal within a few weeks and is not lymphoedema. If you are concerned about any swelling, get it checked by your doctor or nurse. If you have lymphoedema, the arm and hand are more prone to infection. These simple tips can help you look after your skin and reduce the risk of infection.

• Treat even small grazes and cuts with antiseptic and keep them clean until they heal.
• See your GP at the first sign of any infection – if the cut is inflamed or feels warm and tender.
• Avoid getting sunburnt.
• Wear gloves for washing up, DIY and other household tasks.
• Try to avoid being scratched – wear gloves and long-sleeved clothing when handling animals or gardening.
• Use a thimble if you sew.
• Use an electric razor if you shave under your arms.
• Keep your skin clean and dry and use moisturising cream daily to keep it supple.
• Use nail clippers instead of scissors to cut your nails.
• Never push back or cut the cuticles – use cuticle cream instead.