What Are the Long-Term Effects of Breast Cancer Survival?

For breast cancer survivors, the journey doesn’t end once treatment does. From heart health to brain fog, aging brings new challenges

Adam Rosenbluth, M.D.,

AARP

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Published October 06, 2025

illustration of breast cancer survivor with doctor

James Yates

I had radiation and chemo from breast cancer treatments decades ago. What do I need to worry about as I get older?

For many breast cancer survivors, the hardest part isn’t just the treatment — it’s what comes after. Years pass. Hair grows back. Life resumes. But the body remembers, even decades later. New treatments make it possible to think long-term — not just about living, but about how you’ll live as you age. That’s the upside.

The numbers are impressive: These days, 9 in 10 women diagnosed with breast cancer live beyond 5 years, which means a significantly reduced risk of recurrence and a longer lifespan. But as our reader suggests, there could be bumps along the way. If you’re a breast cancer survivor, you’ll want to be on the lookout for them.

Researchers have found that some chemo drugs, notably anthracyclines, plus trastuzumab and radiation — especially if the left side of the chest was treated — raise the risk of a weakening of the heart muscle (cardiomyopathy) or heart failure. There’s also an increased risk of stroke, blockages in the arteries and other cardiovascular troubles. And according to one recent study, these risks persist, even many years after treatment.

In the broader picture, recent research out of UCLA found that breast cancer survivors, whether treated with chemotherapy, radiation or surgery, showed higher markers of overall cellular aging, which results in a greater likelihood of DNA damage, elevated inflammatory pathways and more cellular “senescence.” That’s the name for the process in which more “old cells” stop dividing but don’t die. In some instances, senescense may help prevent cancer, but in others it may contribute to its development and progression.

There are additional long-term side effects. For instance, treatments that affect hormones may cause early menopause. The effects of radiation, coupled with a lack of physical activity during the healing process, can contribute to bone density loss. Over time, this raises the risk of osteoporosis, falls and fractures.

If you’ve had lymph nodes removed or radiation in those areas, the chance of lymphedema, a buildup of lymph fluid in body tissues, remains. Some nerve injuries may show up later, accompanied by pain, weakness or numbness.

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Fortunately, there are plenty of preventative actions you can take. Here’s what I suggest. For one, keep (or get) accurate records of the exact treatments you had, including the chemo agents, radiation fields and dose, and find out whether the left side of your chest was included. This information helps medical experts assess your risk.

Stay proactive with your screenings. Get periodic heart evaluations that include echocardiograms and stress tests. You’ll also want to get bone density tests and have your doctor check for second cancers depending on the area that was irradiated. Be on the lookout for symptoms such as shortness of breath, leg swelling and chest pain.

You’ve heard me say it before, and I’ll stress it again: Lifestyle really matters. Get regular physical exercise, especially cardio and resistance training. Eat a healthy diet with plenty of calcium, vitamin D and fresh fruits, vegetables, nuts and lean proteins. Please avoid excess alcohol and ultra-processed foods, and don’t smoke. You’ll want to maintain a healthy weight and control other risk factors such as blood pressure, cholesterol and diabetes.

Meanwhile, pay attention to your memory and mood and whether you’re experiencing brain fog. Interventions such as cognitive therapy and social support can help.

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It may seem like a lot to track, but you don’t have to manage it all at once. Start with getting or updating your treatment records, schedule a heart evaluation if you haven’t had one in years, check your bone health and speak with your doctor about possible screening for secondary cancers. Small steps now can make a big difference down the road.

Many patients have told me that their experience with cancer changed them, not only by what they lost but what they gained: resilience, clarity about what matters, even deeper relationships and new priorities. Those are real and important gifts. They won’t erase cancer’s challenges, but they can make the long haul easier to travel. Some survivors find that advocating for other breast cancer patients is a rewarding experience and may help save lives.