Living with breast cancer: body image, lymphedema and hormone therapy side effects

Practical help with body changes and intimacy, lowering your risk of lymphedema, managing hormone therapy side effects, fatigue, work and follow-up care after breast cancer.

5 min read · last reviewed September 30, 2026

Breast cancer and its treatment can change your body, your energy and how you feel about yourself. Some changes are short term. Others last longer. Whatever you're going through, you don't have to figure it out alone. There is a lot that helps, and your team wants to hear how you're doing.

Here are some of the most common challenges, and what you can do about them.

Body image and how you feel about yourself

Surgery, hair loss, weight changes and scars can change how you see yourself. You might feel less like "you," or less attractive. These feelings are very common, and they often soften with time.

• Go at your own pace. Look at your scar or new chest when you feel ready. Some people like to have a partner or nurse with them the first time.
• Explore your options. If you had a mastectomy, you can choose a breast form (prosthesis), reconstruction now or later, or living flat. You can change your mind over time.
• Find the right bra or clothing. Specialty fitters and mastectomy bras can make a big difference to comfort and confidence.
• Talk to others who understand. Support groups, in person or online, can help you feel less alone.

Intimacy and sex

Treatment can affect your sex drive, energy, comfort and how you feel about being touched. Hormone therapy and chemotherapy can cause vaginal dryness, which can make sex painful.

• Talk with your partner. Share what feels good and what doesn't. Closeness, touch and cuddling all count.
• Try moisturizers and lubricants. Non-hormonal vaginal moisturizers used regularly, and a water- or silicone-based lubricant during sex, can help a lot.
• Ask about pelvic floor physiotherapy if sex is painful.
• Ask before using any hormone cream. Some are not recommended with certain breast cancers, so check with your team.

Something you can do: It can feel awkward, but bring up sex with your nurse or doctor. They hear these questions every day.

Lymphedema

Lymphedema is swelling caused by fluid building up when lymph nodes have been removed or treated with radiation. After breast cancer, it can affect the arm, hand, breast or chest on the treated side. It can start months or even years after treatment. The risk is lower if only a few nodes were removed.

Early signs to watch for:

• A feeling of heaviness, fullness or tightness in your arm
• Rings, a watch or sleeves feeling tighter on one side
• Swelling that comes and goes, or aching in the arm

What helps lower your risk:

• Keep active and keep a healthy weight. Exercise, including gradual strength training, is safe and helpful.
• Look after your skin. Use moisturizer, wear gloves for gardening, and clean cuts and scratches well.
• Ask your team whether to avoid blood draws, needles or blood pressure checks in that arm. Advice varies.
• Watch for infection. A red, hot, sore arm needs care right away.

If you notice swelling, tell your team early. A certified lymphedema therapist can help with special massage, exercises, compression sleeves and skin care. Early treatment works best.

Hormone therapy side effects

Hormone therapy lowers your chance of the cancer coming back, but its side effects can be hard. The most common are:

• Hot flashes and night sweats. Layered clothing, a cool bedroom and avoiding triggers like alcohol or spicy food may help. Some non-hormonal medicines can also help.
• Joint and muscle aches, especially with aromatase inhibitors. Regular exercise, such as walking, swimming or yoga, often eases them.
• Vaginal dryness, which moisturizers and lubricants can help.
• Bone thinning with aromatase inhibitors. Your team may check your bone density and suggest calcium, vitamin D, exercise or a bone-strengthening medicine.
• Mood changes and trouble sleeping. Tell your team, especially if low mood lasts more than two weeks.

Tamoxifen can also slightly raise the risk of blood clots and uterine problems. Tell your team about any leg swelling or unusual vaginal bleeding.

Please don't stop hormone therapy on your own. Talk to your team first. There are often ways to ease side effects, or other medicines you can switch to.

Fatigue

Cancer-related tiredness is different from everyday tiredness. It may not get better with rest, and it can last for months after treatment. Gentle, regular activity is one of the best ways to boost energy. Plan your day around your best hours, accept help, and let your team know, as things like low blood counts or thyroid problems can add to it.

Work and money

Many people keep working during treatment, work fewer hours or take time off and return later. Talk with your employer about flexible hours or changes to your work. A social worker can help you learn about sick leave, disability benefits and financial support.

Follow-up care

After treatment ends, you'll have regular check-ups, a yearly mammogram if you still have breast tissue, and a plan for any long-term medicines. Between visits, tell your team about any new lump, new pain that doesn't go away, a cough, or anything that worries you. Don't wait for your next appointment.

Something you can do: Ask for a written follow-up plan that says who to see, when, and what to watch for.

Questions to ask your care team

• What side effects might I have from my treatments, and how long might they last?
• What is my risk of lymphedema, and should I see a lymphedema therapist?
• What can I do about hot flashes, joint pain or vaginal dryness?
• Should my bone health be checked?
• Can you refer me to a support group, counsellor or social worker?
• What does my follow-up plan look like, and who do I call with concerns?

This article is general information, not medical advice. Talk with your health care team about your own situation. In an emergency, call 9-1-1 or your local emergency number.

In an emergency, call 9-1-1 or your local emergency number.

General information, not medical advice. It does not replace your own care team. If you think you or someone else is having a medical emergency, call 9-1-1 or your local emergency number. If you are in crisis or thinking about suicide, call or text 9-8-8 (Canada and the US).

Back to Breast cancer