Pattern of follow-up care and early relapse detection in breast cancer patients

Geurts, S.M.E.; Vegt, Femmie de; Siesling, Sabine; Flobbe, Karin; Aben, Katja K.H.; Loo, Margriet van der Heiden‐van der; Verbeek, A.L.M.; Dijck, J.A.A.M. van; Tjan‐Heijnen, Vivianne C. G.

doi:10.1007/s10549-012-2297-9

Cited by 41 publications

(43 citation statements)

References 23 publications

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“…We can consider our patients were regularly monitored, as there was only 13.2% missing mammographies during the first 5 years. Previous studies reported 8.7%‐28% missing mammographies during the first year and 29%‐40.7% during the second year . The time between the last mammography and the recurrence was 12.3 months (1.2 months to 5.1 years) in our study, compared to 16.4 months reported by Paszat et al .…”

Section: Discussioncontrasting

confidence: 57%

Pattern of relapse in low-risk breast cancer patients followed within a community care network

Agopian¹,

Dubot

Houzard³

et al. 2017

Breast J

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International guidelines have set the frame and methods of patients' surveillance after early breast cancer (BC) treatment. Since 1998, delegation of low-risk BC patients follow-up to nonhospital practitioners has been developed within a care network in the Paris region. We used the Gynecomed care network digital database to describe the characteristics of oncological events which occurred in the cohort, and to assess the quality of BC follow-up in relapsing patients. Events were defined as any local, contralateral, or metastatic recurrence, as well as second cancer or death due to any cause. We developed a ranked evaluation method of our surveillance program. Among the 3019 patients followed in the network, 116 (4.3%) patients had 116 events. Median follow-up was 7.1 years (0-51). First events were local-regional relapses, contralateral BCs, metastatic events, second primaries in respectively 52, 26, 14, 24 cases. During the first 5 years, 68.4% of surveillance visits were performed on time, 13.5% were behind schedule and 18.1% were not performed, while 79.1% of mammographies were performed on time, 7.7% behind schedule, and 13.2% were not performed. On schedule examinations allowed diagnosis of 77% of the local-regional, ipsilateral relapses or contralateral BCs, including 38 (69%) discovered by mammographies and 17 (31%) by clinical examination. A nonhospital practitioner care network is able to comply with good surveillance practices and deliver high quality surveillance, in accordance with international guidelines. Delegation of low-risk BC surveillance to nonhospital practitioners is reliable.

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Section: Discussioncontrasting

confidence: 57%

Pattern of relapse in low-risk breast cancer patients followed within a community care network

Agopian¹,

Dubot

Houzard³

et al. 2017

Breast J

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“…The studies focusing on follow-up care in BCSs have been conducted in different populations worldwide, most of them in the US (n=19),27,33–36,41–43,46,53–59,63–65 followed by the UK (n=10),26,31,32,39,40,45,51,52,61,62 and the Netherlands (n=7) 23,24,38,44,48,49,60…”

Section: Resultsmentioning

confidence: 99%

“…Table 6 summarizes six studies assessing the effectiveness of follow-up care in BCSs, where each study evaluated a different outcome including mortality, detection of recurrence, increase in surveillance testing, and reduction in anxiety 60–65. For example, the results of two studies showed that surveillance mammography was effective in reducing breast cancer mortality 63.…”

Section: Resultsmentioning

confidence: 99%

Follow-up care for breast cancer survivors: improving patient outcomes

Chopra¹,

Chopra²

2014

PROM

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BackgroundAppropriate follow-up care is important for improving health outcomes in breast cancer survivors (BCSs) and requires determination of the optimum intensity of clinical examination and surveillance, assessment of models of follow-up care such as primary care-based follow-up, an understanding of the goals of follow-up care, and unique psychosocial aspects of care for these patients. The objective of this systematic review was to identify studies focusing on follow-up care in BCSs from the patient’s and physician’s perspective or from patterns of care and to integrate primary empirical evidence on the different aspects of follow-up care from these studies.MethodsA comprehensive literature review and evaluation was conducted for all relevant publications in English from January 1, 1990 to December 31, 2013 using electronic databases. Studies were included in the final review if they focused on BCS’s preferences and perceptions, physician’s perceptions, patterns of care, and effectiveness of follow-up care.ResultsA total of 47 studies assessing the different aspects of follow-up care were included in the review, with a majority of studies (n=13) evaluating the pattern of follow-up care in BCSs, followed by studies focusing on BCS’s perceptions (n=9) and preferences (n=9). Most of the studies reported variations in recommended frequency, duration, and intensity of follow-up care as well as frequency of mammogram screening. In addition, variations were noted in patient preferences for type of health care provider (specialist versus non-specialist). Further, BCSs perceived a lack of psychosocial support and information for management of side effects.ConclusionThe studies reviewed, conducted in a range of settings, reflect variations in different aspects of follow-up care. Further, this review also provides useful insight into the unique concerns and needs of BCSs for follow-up care. Thus, clinicians and decision-makers need to understand BCS’s preferences in providing appropriate follow-up care tailored specifically for each patient.

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“…Such practices result in a disproportionate number of overdiagnoses (FPs). Similarly, advanced technologies may have limited value for routine follow-up examinations of cancer patients [23,24].…”

Section: Clinical Practice and Theoretical Considerationsmentioning

confidence: 99%