For patients in breast cancer remission, what is next?

Depending on whether a patient's cancer was estrogen-positive or estrogen-negative, he or she may have medications to take - or none at all. Breast exams are a must for both.

When breast cancer patients hear their doctor say the word remission, it's a time to exhale with relief.

However, there are several types of remission, and this can include further treatments and/or medication plans for the following months or years.

Remission includes:

A complete response to treatment is complete disappearance of cancer, and called complete remission;

A partial response is a 50 percent or more reduction in the size of the tumor; and

A minimal response is less than 50 percent reduction.

Other terms used after treatment are stabilization, which means that the cancer remains the same. Progression indicates the cancer is growing and enlarging.

"If a patient has had estrogen-positive breast cancer, then medications for three to five years will be prescribed, with tamoxifen the most widely used. There is a positive side effect of tamoxifen, that it makes your bones stronger," said Dr. Julie Nangia, assistant professor, Lester & Sue Smith Breast Center, Baylor College of Medicine.

According to Nangia, there are a number of different drugs prescribed for those in remission, which may include anastrozole (Arimidex), letrozole (Femara) or exemestane (Aromasin).

"We also recommend those in remission to be checked every three to six months for five years from the date of diagnoses. Most doctors do not follow up with scans. Yet, we do for those considered at high-risk for a reoccurrence. We screen with an MRI and mammogram every six months. Some insurance will not cover both MRIs and mammograms, but we recommend requesting it," Nangia said.

For those who have been diagnosed with estrogen-negative, there are no follow-up medications.

"It is important for all, including estrogen-negative patients, to have breast exams every six months for five years. Those who have had breast cancer are a higher risk to have a reoccurrence. If one breast has been removed, there is a risk the second breast will be diagnosed with breast cancer," Nangia said.

It is also important to keep up with annual exams and self-checking, but most of all, return to a normal life as soon as possible.

"It is also important to have a healthy diet, and exercise at least 30 minutes a day, three to five days a week, and have no more than three alcoholic drinks a week, or less," Nangia said.

According to National Comprehensive Cancer Network, women with an intact uterus who are taking adjuvant tamoxifen should have a yearly gynecological checkup. If there is any vaginal spotting, which is not unusual with tamoxifen, it is important to see your doctor immediately.

Symptom management for women on hormone therapies often requires treatment of hot flashes and for concurrent depression. Venlafaxine has been studied and is an effective intervention in decreasing hot flashes.

With every day that passes, progress is being made with medications and treatments. The National Breast Cancer Coalition has a mission and a blueprint for ending breast cancer by 2020, which is just a little over six years away.

To access its plan, go to www.breastcancerdeadline2020.org.