After completing this article, readers should be able to: (1) Define breast cancer survivorship and surveillance. (2) Understand breast cancer recurrence mechanisms and risks. (3) Describe risks of metastasis and mortality for breast cancer survivors. (4) Understand risk factors for second primary cancers in breast cancer survivors. (5) List reasons for follow-up and surveillance of breast cancer survivors. (6) Understand quality-of-life issues for survivors and how they interact with breast cancer recurrence. (7) Explain the roles of mammography surveillance and other imaging methods in detecting breast cancer recurrence. Breast cancer may be the second most common nonskin cancer among women, but it is not a modern disease. Ancient people were aware of breast tumors, even if their treatment methods were less than desirable by today's standards. The sixth century Byzantine empress Theodora discovered a lump in her breast in 548 and died in the same year, choosing death over surgery. More than 1100 years later, in 1663, Queen Mother of France Anne of Austria noticed a lump in her left breast. Her anxiety was high, having seen several nuns at Val-de-Grace convent just outside Paris die from the disease. She delayed seeking treatment until the pain was too great to ignore, and the tumor spread deep into her breast and under her arm.
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