Follow-up strategies for women treated for early breast cancer

Rojas, Maria Paulina MP; Telaro, Elena; Moschetti, Ivan; Coe, Laura; Fossati, Roldano; Liberati, Alessandro; Rosselli, Marco Del Turco

doi:10.1002/14651858.cd001768.pub2

Cited by 113 publications

(105 citation statements)

References 19 publications

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“…53,54,56,59,60 Only six studies reported data on numbers of patients experiencing IBTR and/or MCBC events. [53][54][55][56][57][58] The paucity of the underlying evidence base mirrors the findings of previous reviews 4,29,[43][44][45][46][47] described earlier. Nevertheless, a number of conclusions may be drawn.…”

Section: Discussionsupporting

confidence: 72%

“…There have been suggestions that follow-up could be transferred to the primary care setting with the general practitioner (GP) performing a similar role to the specialist clinician during the clinical examination. 29,41 If a GP detects a possible IBTR or MCBC, they should refer the patient back to the secondary care breast unit for further investigation. 21,24 Primary care follow-up also encompasses the role of the GP in assessment and referral of patients presenting in primary care with self-reported symptoms.…”

Section: Physical Examination Tests Specialist-led Clinical Examinationmentioning

confidence: 99%

“…The American Society of Clinical Oncology 28 recommended in 2006 that surveillance should include annual mammography, although acknowledging that there is a lack of high level evidence to support decisions about the frequency and timing of mammographic surveillance. Seven reviews, 4,29,41,[43][44][45][46][47][48] of varying methodological quality, have summarised the evidence of the effectiveness of differing surveillance regimens after treatment for breast cancer.…”

Section: Decision Problemmentioning

confidence: 99%

“…yearly mammography compared with 6-monthly mammography) or to analyse the effect of prognostic factors such as age, tumour stage and surgical treatment. Rojas and colleagues 29 focused on the effectiveness of different surveillance policies for the detection of distant metastatic disease and concluded that follow-up programmes of regular physical examination and yearly mammography alone are as effective as more intensive approaches involving laboratory and radiological tests in terms of timeliness of detection of tumour recurrences, overall survival and quality of life. In addition, follow-up of patients performed by a trained general primary care practitioner is comparable to that of hospital-based secondary care specialists in terms of detection of tumour recurrence and quality of life.…”

Section: Decision Problemmentioning

confidence: 99%

“…It is unclear which of these alternative methods of organising a service represent the most effective and efficient regimen. Previous systematic reviews 4,29,[43][44][45][46][47] have been unable to clarify the optimal frequency and duration of surveillance mammography.…”

Section: Overviewmentioning

confidence: 99%

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The clinical effectiveness and cost-effectiveness of different surveillance mammography regimens after the treatment for primary breast cancer: systematic reviews, registry database analyses and economic evaluation

2012

Clinical Governance: An International Journal

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAThe clinical effectiveness and costeffectiveness of different surveillance mammography regimens after the treatment for primary breast cancer: systematic reviews, registry database analyses and economic evaluation NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indir...

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Section: Discussionsupporting

confidence: 72%

Section: Physical Examination Tests Specialist-led Clinical Examinationmentioning

confidence: 99%

Section: Decision Problemmentioning

confidence: 99%

Section: Decision Problemmentioning

confidence: 99%

Section: Overviewmentioning

confidence: 99%

See 3 more Smart Citations

The clinical effectiveness and cost-effectiveness of different surveillance mammography regimens after the treatment for primary breast cancer: systematic reviews, registry database analyses and economic evaluation

2012

Clinical Governance: An International Journal

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Follow-up strategies for women treated for early breast cancer

Moschetti

Cinquini

Lambertini

et al. 2016

Cochrane Database of Systematic Reviews

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153

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Cochrane Database of Systematic Reviews analyses according to patient age, tumour size and lymph node status before primary treatment. In 1999, 10-year follow-up data became available for one trial of these trials, and no significant di erences in overall survival were found. No di erence was noted in quality of life measures (one study, 639 participants, high-quality evidence). The new included trial, together with a previously included trial involving 1264 women compared follow-up performed by a hospitalbased specialist versus follow-up performed by general practitioners. No significant di erences were noted in overall survival (HR 1.07, 95% CI 0.64 to 1.78, one study, 968 participants, moderate-quality evidence), time to detection of recurrence (HR 1.06, 95% CI 0.76 to 1.47, two studies, 1264 participants, moderate-quality evidence), and quality of life (one study, 356 participants, high-quality evidence). Patient satisfaction was greater among patients treated by general practitioners. One RCT involving 196 women compared regularly scheduled follow-up visits versus less frequent visits restricted to the time of mammography. No significant di erences emerged in interim use of telephone and frequency of general practitioners's consultations. Authors' conclusions This updated review of RCTs conducted almost 20 years ago suggests that follow-up programs based on regular physical examinations and yearly mammography alone are as e ective as more intensive approaches based on regular performance of laboratory and instrumental tests in terms of timeliness of recurrence detection, overall survival and quality of life. In two RCTs, follow-up care performed by trained and not trained general practitioners working in an organised practice setting had comparable e ectiveness to that delivered by hospital-based specialists in terms of overall survival, recurrence detection, and quality of life.

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