Abstract
Extended follow-up of breast cancer patients in clinic wastes time for both patients and doctors: the case against.
Highlights
The question to be addressed is not really whether there is any evidence to support ceasing clinical follow-up there is none. Until such a time that there is a properly powered randomized trial that proves that there is no benefit to patients from being reviewed clinically on a regular basis, we have no evidence to stop doing what most of us, and most of our patients, feel is appropriate - keeping in regular clinical contact
No difference was found in time to diagnosis of relapse or in quality of life, but the investigators did report that patients being followed up in general practice had more, and longer, visits than those in the secondary care sector, but were more satisfied [7,8]
The Ontario guidelines recognize that there are no randomized data to support this approach, there is reasonable level C evidence to support its use to detect both ipsilateral recurrence and contralateral second primary breast cancer [11]. Organizing such regular mammography does not need regular clinic visits but, unless for example it is done within a systematic national breast screening programme, few health care systems are currently in a position to provide this service for breast cancer patients without being based within a clinical structure
Summary
None reported but literature relatively underpowered Never been tested in a randomized trial Recommendations have not been tested in randomized controlled trials No evidence provided for the recommended limit of follow-up to 2 to 3 years Local recurrence risk maintained for much longer than recommended follow-up period Seems acceptable and good, but small trial (
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