Patient's needs and preferences in routine follow-up after treatment for breast cancer

Abstract

The purpose of the study was to analyse the needs of women who participated in a routine follow-up programme after treatment for primary breast cancer. A cross-sectional survey was conducted using a postal questionnaire among women without any sign of relapse during the routine follow-up period. The questionnaire was sent 2 -4 years after primary surgical treatment. Most important to patients was information on long-term effects of treatment and prognosis, discussion of prevention of breast cancer and hereditary factors and changes in the untreated breast. Patients preferred additional investigations (such as X-ray and blood tests) to be part of routine follow-up visits. Less satisfaction with interpersonal aspects and higher scores on the Hospital Anxiety and Depression Scale (HADS) scale were related to stronger preferences for additional investigation. Receiving adjuvant hormonal or radiotherapy was related to a preference for a more intensive follow-up schedule. There were no significant differences between patients treated with mastectomy compared to treated with breast-conserving therapy. During routine follow-up after a diagnosis of breast cancer, not all patients needed all types of information. When introducing alternative follow-up schedules, individual patients' information needs and preferences should be identified early and incorporated into the follow-up routine care, to target resources and maximise the likelihood that positive patient outcomes will result.

Patients’ needs and preferences in routine follow-up for early breast cancer; an evaluation of the changing role of the nurse practitioner

“…In a previous publication, patients in group A preferred multiple follow-up visits per year after a median follow-up of three years 2 . This is comparable to the preference of group B in this study with a similar follow-up duration; almost 75% of these patients preferred visits more frequently than M A N U S C R I P T…”

“…The first group, group A, consisted of patients operated before the introduction of the breast cancer unit (1998-1999, n=89) and had previously participated in a patient satisfaction survey in 2004 2 . These patients were only incidentally seen by a nurse practitioner.…”

Models of Care for Early-Stage Breast Cancer in Canada

“…A survey carried out in 2001 in the Netherlands among women 2-4 years post treatment for ebc reported that more than half the patients preferred lifetime follow-up twice annually, and 86% preferred follow-up by a hospitalbased physician 33 . Similarly, among 285 women with ebc in the United Kingdom, 85% preferred regular follow-up in a breast clinic, and 76% preferred regular breast clinic visits rather than family physician follow-up 34 .…”

Moving Forward: A Qualitative Research Inquiry to Inform the Development of a Resource Pack for Women Following Primary Breast Cancer Treatment

“…Several studies have highlighted that high levels of distress in the transition period can result in poorer long-term adjustment (Cimprich et al, 2005;Allen et al, 2009 information needs are associated with higher anxiety and depression (De Bock et al, 2004) and ongoing physical and psychological symptoms can lead to poorer quality of life (Cappiello et al, 2007). Given the current changes taking place in cancer care, coupled with an identified need both for tools for cancer survivors and the lack of research to inform what is needed at this time, it is timely to conduct this research to ask what cancer survivors want from a resource at the end of their active treatment and transition to ongoing survivorship.…”