What sort of follow up nedded?

Hello
I am a 10 year survivor (45 years old now) of Ductal Carcinoma with microinvasion, negative nodes.  I did not receive any chemo.  I am not on Tamoxifen (couldn't take it due to severe side effects).  No family history.

No one has suggested any kind of follow up for me.  The first few years, they had me doing some general blood work and a ca15-3, but nothing now.  In fact, we recently moved here to Detroit, and when I went to the doctor and asked her this question, she appeared quite baffled.  She said I wouldn't need any follow up, that I was "probably cured".  I went to another FP doc a few weeks ago for something else, and the response was similar.  No follow up needed.  Even my old GYN doc back home last year said there is nothing they would do in the way of follow up.

Have had bilateral mastectomies and am not yet menopausal.  I just have a fear of late onset metastatic disease, and have a hard time believing that I am "cured", never having to worry about late metastatic disease.  I don't sit around obsessing, but i feel uneasy about it from time to time.

Is there anything I should be doing?  My doc doesn't even think a consult with an oncologist is warrented, so unless she agrees to refer me, I can't go.
Should I just shut up and be happy, and not worry at all?

[CCF-RN,MSN-rf]

Dear Christie:  In terms of any specific testing, your doctors are right.  There really isn't anything that would be reasonable to do.  In general, in situations like yours, the rule of thumb is to have a low threshold for investigating any new symptom.  For example, a physician might order a CT scan if you were to develop any new symptom.  Another - previously healthy individual - might go through other tests before getting a CT scan.  Having said that, many women who are in situations like yours are followed by an oncologist - even if the visit is only once a year.  Many times it is the person who made the recommendations after surgery.  Even though all is well now and you, by all measurements, have an excellent prognosis, if you would feel more comfortable, ask for an oncology referral.  This may be important to your mental health.

[surgeon]

I'd agree that having had bilateral mastectomy and being a 10 year survivor, your risk of recurrance is very close to zero, and your risk of developing a new breast cancer has been eliminated. So there really is no specific followup needed. You could (should?) have an annual physical; routine lab work to include screening blood tests of the liver, and blood count would be a rough screening. But really, the best test at this point is if you feel fine. Sounds crude; but it's true.

[nurse12hr]

Cool!  Thanks.