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Symptoms may include physical, functional, emotional, and psychosocial changes that can dramatically alter the quality of life for breast cancer survivors. Primary care clinicians, including midwives, are likely to care for these women and should be familiar with common symptoms, treatment, and best practices to avoid permanent dysfunction. A holistic approach to assessment, treatment, and referral as needed is the most effective strategy. Although women experience significant changes after breast cancer treatment, many fail to receive thorough assessment of their symptoms, education about interventions, and treatment options to optimize health promoting strategies. Disparities exist in treatment availability, options, and survivorship. Long\u2010term physical changes include anatomic changes, chronic pain, phantom breast pain, axillary web syndrome, and lymphedema. In addition, women may have decreased strength, aerobic capacity, mobility, fatigue, and cognitive dysfunction. Emotional and psychosocial changes include depression, anxiety, fatigue, concerns about body image, and issues with sexuality. Treatment should be multifactorial based on thorough assessment of symptoms and can include medication, exercise, counseling, physical and occupational therapy, and alternative and complementary therapies. Primary care and gynecologic clinicians are well positioned to provide thorough evaluation, education, treatment, and referral for the most common sequelae of mastectomy and breast cancer treatments.<\/jats:p>","DOI":"10.1111\/jmwh.13012","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T08:37:11Z","timestamp":1563525431000},"page":"713-724","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":370,"title":["Long\u2010Term Effects of Breast Cancer Surgery, Treatment, and Survivor Care"],"prefix":"10.1111","volume":"64","author":[{"given":"Dawn L.","family":"Lovelace","sequence":"first","affiliation":[{"name":"Frontier Nursing University  Hyden Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda R.","family":"McDaniel","sequence":"additional","affiliation":[{"name":"Frontier Nursing University  Hyden Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dwynn","family":"Golden","sequence":"additional","affiliation":[{"name":"Frontier Nursing University  Hyden Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,19]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Cancer Facts & Figures 2018","author":"American Cancer Society","year":"2018"},{"key":"e_1_2_8_3_1","volume-title":"Breast Cancer 2018 Fact Sheet","author":"World Health Organization; International Agency for Research on Cancer","year":"2018"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NAJ.0000484223.07306.45"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.2895"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5443-5"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2016.05.05"},{"issue":"5","key":"e_1_2_8_8_1","first-page":"535","article-title":"Breast intervention and breast cancer treatment options","volume":"86","author":"Peart O","year":"2015","journal-title":"Radiol Technol"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-043015-075227"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2012.07.008"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2016.06.004"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0096748"},{"key":"e_1_2_8_13_1","unstructured":"Sentinel lymph node biopsy. 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