Abstract
Extended follow-up of breast cancer patients in clinic wastes time for both patients and doctors: the case for
Highlights
Numerous organizations have provided guidelines for clinical follow-up of women after they have undergone breast cancer treatment
The Canadian Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer are more pragmatic regarding the frequency of visits, and suggests that these should be tailored to individual patient needs, but their recommendations explicitly state that follow-up should be provided indefinitely [2]
The National Institute for Health and Clinical Excellence (NICE) in the UK suggests that clinical follow-up should be limited to only 2 or 3 years [3]
Summary
Numerous organizations have provided guidelines for clinical follow-up of women after they have undergone breast cancer treatment. There is clearly disagreement between the groups that have published guidelines, but common to all of the guidelines is an emphasis on providing intensive follow-up during the first 3 to 5 years after diagnosis and treatment, with either reduced frequency of visits or discharge to the general practitioner thereafter The bases of these guidelines are the perceptions that recurrent disease is most common in the first 3 to 5 years after treatment and that clinical examination remains an important component of follow-up. More effective systemic therapies are available, and so potentially there is scope for another trial using investigations such as magnetic resonance imaging or computed tomography positron emission scanning Such a study is currently being planned by the Eastern Cooperative Group in the USA but, outside such a study, there can be no justification for performing investigations to detect metastatic disease in asymptomatic patients during follow-up. This suggests that such visits do not contribute significantly to the detection and amelioration of physical or psychosocial problems
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