Surveillance for lingering physical and emotional affects of breast cancer becomes part of a patient's lifelong routine.  But that does not mean she shouldn't live a full life.  

Breast cancer survivors will tell you that healing is not an event, but a journey with many stops and starts along the way. 

The primary concern of most survivors is to be reassured that the cancer won't recur – that they can, at some point, stop looking over their shoulders.  Five-year survival rates are the most frequently-published data because 50% of breast cancer recurrences develop in the first three years after diagnosis.  But, breast cancer can recur even after twenty years, and the well-known propensity for delayed onset of metastatic disease with breast cancer makes it a lifelong issue.  That means that women must learn to cope with a sense of uncertainty and lack of control that may diminish over time but never completely goes away. 

Other emotional issues can be almost as challenging.  As many as 30 percent of women who have had breast cancer suffer from prolonged anxiety and depression.  For some women, the breasts are an essential source of female self-image. Cancer of the breast may seriously affect their perception of identity.  They may experience feelings of decreased attractiveness and fear that their partners will abandon them.  Survivors can experience profound feelings of guilt.  Women worry that they may have done something to cause the disease, that they may have passed a genetic predisposition for the disease to their daughters, that they have been a burden to their caregivers and even that they survived the disease and others didn't.

Finally, continuing physical effects like problems with sexual function, fertility, pregnancy, menopause, and lymphedema can be draining.  A new study reports that although most breast cancer survivors do not experience long-term fatigue, one in five still feel tired up to ten years after diagnosis.

How do women get through it all and create a really good life for themselves?  Survivors who make the transition have several things in common.

• They confide in someone, whether a partner, a friend or a professional, about their feelings.  People who keep their anguish to themselves tend to develop more symptoms and suffer more pain than those who share their feelings.  
  
  
• They recognize (and internalize) that even really healthy people get breast cancer.  They are not to blame.
  
  
• They recognize (and internalize) that their breasts do not equate to who they are. 
  
  
• They allow themselves to grieve; then they get up, dust themselves off, and persevere.
  
  
• They build stronger relationships their partners, their children and their friends through open and honest communication.
  
  
• They only attempt to control what they can control and let the other stuff go.

Amazingly, some women come to believe their breast cancer was a "gift."  They find strength in themselves that they never knew existed.  They learn empathy for others to a degree they never expected.  They learn how much other people care about them.  They learn to embrace each day and live in the moment.  They seek and find new meaning in their lives.   In short, they triumph over breast cancer.