Breast cancer patients should be given better mental health support, charities have said.
More than eight in 10 (84%) women diagnosed with the disease in England were not warned about the possible long-term emotional impact it will have, according to a survey by Breast Cancer Care.
A third (33%) revealed they experienced anxiety for the first time in their lives after diagnosis and treatment.
Breast Cancer Care and charity Mind are calling for all women with the disease to be told about the risk of developing depression and other mental health problems, and to be offered support when they need it.
The survey involved 2,862 women in England with primary breast cancer who had finished hospital treatment.
Almost half (45%) continuously fear that their cancer may return, while one fifth (19%) said they experienced social isolation after treatment ended.
Lauren Faye (pictured), 28, from Bristol, who was diagnosed with breast cancer in June 2016, said she has struggled with social isolation and anxiety since her treatment.
The impact the cancer could have on her mental health was not mentioned by her healthcare team, she said.
She added: "My last hospital appointment felt like a huge anti-climax. I'd been so caught up in the whirlwind of treatment, I didn't anticipate how hard moving forward would be.
"I felt isolated from my friends as I had no energy to go out with them, and I had to watch from the sidelines as they all got on with their careers, relationships and lives."
Samia al Qadhi, chief executive of Breast Cancer Care, said the figures highlight the "stark reality of life after breast cancer".
She said: "Damaged body image, anxieties about the cancer returning and debilitating long-term side effects can disrupt identities and shatter confidence, leaving people feeling incredibly lonely, and at odds with friends, family and the outside world.
"We know people expect to feel better when they finish treatment and can be utterly devastated and demoralised to find it the hardest part.
"And though the NHS is severely overstretched, it's crucial people have a conversation about their mental health at the end of treatment so they can get the support they need, at the right time."
Stephen Buckley, head of information at Mind, said: "Health professionals should treat each person as a whole and, if treating someone for their physical health, also offer ongoing support for their mental health.
"If nothing else, starting the conversation means that the person is more likely to recognise the impact their condition may have on their wellbeing and feel able to seek support if they need it.
"We need to see longer term support for those who are either receiving or coming to the end of their cancer treatment."
Copyright (c) Press Association Ltd. 2018, All Rights Reserved. Picture (c) Lauren Faye / PA Wire.