VII. FOLLOW-UP

Follow-up na behandeling van primair mammacarcinoom heeft vier motieven:

1. zorg voor de patiënte

2. detectie van recidief ziekteactiviteit

3. detectie van een 2^e primaire tumor

4. medisch-technische aspecten die gericht zijn op het in kaart brengen en behandelen van de gevolgen van de behandeling

1. Locoregionaal recidief

Zie gelijknamige hoofdstuk.

2. Metastasen op afstand

3. Nieuwe primaire tumor in de contralaterale mamma

4. Bijwerkingen van de therapie van primair mammacarcinoom

5. Anticonceptie en zwangerschap na behandeling

Ongeveer 15% van alle vrouwen met borstkanker is jonger dan 45 jaar en heeft mogelijk nog een kinderwens. Wanneer een vrouw besluit zwanger te willen worden is het raadzaam recidief mammacarcinoom of een tweede primaire tumor zoveel mogelijk uit te sluiten met behulp van mammografie. Ook wordt geadviseerd dan de behandeling met tamoxifen te staken.

Het gebruik van orale anticonceptie wordt afgeraden bij borstkankerpatiënten. Dit advies is gebaseerd op indirecte bewijsvoering: de rol van oestrogenen in het ontstaan van borstkanker en de bewezen effectiviteit van anti- oestrogene therapie bij borstkanker.

6. Hormonale suppletietherapie bij vrouwen met borstkanker

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