Getting through treatment is only the beginning.

As the ranks of cancer survivors have swelled to more than 10 million, their health has attracted increasing attention from scientists and physicians. The impact of breast cancer is as individual as the women who survive it. It can be an arduous though temporary challenge or an experience so transformative that it divides existence into two parts — before and after.

A woman should work with her doctors to create a “survivorship plan” that includes addressing the long-term emotional effects of breast cancer. Typically, a woman marshals all her psychological defenses to get through treatment. When therapy is over, she can finally let her guard down but then may be flooded with intense and conflicting emotions, which may include the following:

Fear and anxiety. For women who have just completed chemotherapy or radiation — or five years of tamoxifen therapy — the end of active cancer treatment can be disconcerting. After months of regular medical care and attention, they often find themselves abruptly severed from the oncology team that’s sustained them during treatment. Equally common, and more distressing, is the specter of recurrence, which can color every aspect of life.

Grief. Breast cancer brings loss — be it as minor as the claim to perfect health or as monumental as the ability to have children. Grieving is a natural response to loss, and it may take months or years to complete.

Erosion of self-image. The physical effects of treatment — loss of a breast, hair loss, weight gain, radiation burns, and surgical scars — are reminders of one’s vulnerability. Breast cancer survivors may feel that they’re less attractive and that their vitality is diminished. The adjustments can be especially hard for young women who are thrown into menopause by chemotherapy.

Changes in intimate relationships. It goes without saying that a woman’s sex life is affected by breast cancer. Illness is a notorious thief of libido. In addition, a survivor’s partner may feel breast cancer’s toll on body and body image as deeply as the survivor herself.

Effects on the family. Breast cancer is a family affair. Family members are likely to want to get the household back to normal after treatment ends, and they may not be patient with the partner or mother who needs more time to recover.

If you’re a breast cancer survivor, these steps may help you develop a “survivorship plan” to maximize your physical and emotional health:

Work closely with your primary care doctor. It’s important to make sure your clinician has your complete cancer history — including surgical reports, radiology records, and drug information.

Join a support group. Breast cancer survivorship may not be a sorority you ever intended to join, but its ranks are legion. It can be therapeutic to talk with someone who’s walked in your shoes.

Stabilize your relationships. If cancer has put a strain on your relationships or unearthed problems that took root earlier, consider getting help from a mental health professional.

Treat yourself. Make a list of things that might give you pleasure — from a vase of fresh flowers to a visit to a day spa — and schedule them into your life.

Invest in the future. This can be something as small as planting an amaryllis bulb to bloom in a few months or as large as launching a new career. Planning for the future is one of the best ways to overcome the fear that it won’t be there.

For more information on regarding diagnosis, treatment and prevention of breast cancer, order our special health report Breast Cancer: Strategies for living, available at www.health.harvard.edu/BC.