The Reality in the Surveillance of Breast Cancer Survivors—Results of a Patient Survey

Hans-Joachim, Stemmler; Lässig, Dorit; Stieber, P.; Bauerfeind, Ingo; Kahlert, S.; Alexander, Fasching Peter; Wilhelm, Beckmann Matthias; Glattes, Margrit; Goldmann-Posch, Ursula; Verena, Hoffmann; Untch, Michael; Heinemann, Volker

doi:10.4137/bcbcr.s511

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…Follow-up tests themselves also may cause psychosocial and physical harm in healthy survivors owing to false-positive findings, unnecessary investigations, and overtreatment [ 16 ]. Despite these reports, both patients and physicians in actual clinical situations do not perform present follow-up guidelines and conduct a variety of surveillances under the belief that intensified follow-up will increase diagnostic security and survival [ 10 , 11 ]. In other words, despite the evidence of well-designed randomized controlled trial, there are still a lot of debates on optimal follow-up modality, frequency, and duration for breast cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

“…In actual clinical situation, however, most breast cancer survivors want to receive more examinations because they are afraid of the recurrence when conducting follow-up after the primary treatment. Many physicians also tend to perform more tests more frequently than the extent recommended by the guidelines under the belief that they can increase the survival rate despite lack of evidence [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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The reality in the follow-up of breast cancer survivors: survey of Korean Breast Cancer Society

Kim¹,

Kim

Shim

et al. 2015

Ann Surg Treat Res

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PurposeFollow-up after primary treatment for breast cancer is an important component of survivor care and various international guidelines exist for the surveillance. However, little is known about current actual practice patterns of physicians whether they adhere to or deviate from recommended guidelines. The aim of this study was to determine how physicians follow-up their patients after primary treatment for breast cancer in Korea.MethodsA questionnaire survey with 34 questions in 4 categories was e-mailed to the members of Korean Breast Cancer Society from November to December 2013. Respondents were asked how they use follow-up modalities after primary treatment of breast cancer and we compared the survey results with present guidelines.ResultsOf the 129 respondents, 123 (95.3%) were breast surgeons. The most important consideration in follow-up was tumor stage. History taking, physical examinations, and mammography were conducted in similar frequency recommended by other guidelines while breast ultrasonography was performed more often. The advanced imaging studies such as CT, MRI, and bone scan, which had been recommended to be conducted only if necessary, were also examined more frequently. Regular screenings for secondary malignancy were performed in 38 respondents (29.5%). Five years later after primary treatment, almost the whole respondents (94.6%) themselves monitored their patients.ConclusionA majority of respondents have been performed more intensive follow-up modalities in comparison with present guidelines and less frequently screenings for secondary malignancy. For optimal follow-up of breast cancer survivors, tailored delivery system should be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The reality in the follow-up of breast cancer survivors: survey of Korean Breast Cancer Society

Kim¹,

Kim

Shim

et al. 2015

Ann Surg Treat Res

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“…As demonstrated in other medical disciplines, patients may get reassurance, satisfaction with their care, a stronger sense of control, or may value the prognostic information gained from testing . In the field of oncology, surveillance testing specifically has been shown to provide reassurance . On the other hand, surveillance imaging may cause harm.…”

Section: Recommendationsmentioning

confidence: 99%

AHNS Series-Do you know your guidelines? Guideline recommended follow-up and surveillance of head and neck cancer survivors

2016

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In this first article of the "Do You Know Your Guidelines" series, we review National Comprehensive Cancer Network (NCCN) recommendations and underlying evidence for the follow-up and surveillance of head and neck cancer survivors. The goals of follow-up and surveillance care are (1) to maximize long-term oncologic outcomes of therapy with appropriate evaluation for recurrence, (2) to maximize functional and quality of life outcomes, and (3) minimizing unnecessary and harmful low-value care. Finding the right balance of testing and surveillance is a challenge for providers and patients. Herein, we review all NCCN recommendations for head and neck cancer survivors. We pay particular attention to an area of controversy: the use of ongoing surveillance imaging, in particular, PET/CT scans.

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“…First, the patient-driven anxiety and the feeling of reassurance induced by intensive postoperative surveillance, including the BS. Stemmler et al have examined 801 questionnaires of German women with a history of BC and reported that more than 47.8% of them needed an intensive schedule, which increased their feeling of security [ 27 ]. Second, patients with early or limited metastatic recurrence may be curable; thus, the monitoring of asymptomatic patients could result in better efficacy of BC treatment, at least in theory, when tumor burden is low [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Survival in Breast Cancer Patients with Bone Metastasis: A Multicenter Real-World Study on the Prognostic Impact of Intensive Postoperative Bone Scan after Initial Diagnosis of Breast Cancer (CSBrS-023)

Yang

et al. 2022

Cancers

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The prognostic value of intensive postoperative bone scan (BS) screening, which is performed in asymptomatic patients with breast cancer (BC) after surgery, remained unclear. Patients diagnosed with BC with bone metastasis (BM) from five medical centers in China during the years 2005–2013 were retrospectively collected. Propensity score matching (PSM) was performed to balance the baseline characteristics. The survival outcomes were overall survival (OS) and overall survival after BM (OSABM). Among 1059 eligible patients, 304 underwent intensive postoperative BS while 755 did not. During a median follow-up of 6.67 years (95%CI 6.45, 7.21), intensive postoperative BS prolonged the median OS by 1.63 years (Log-Rank p = 0.006) and OSABM by 0.66 years (Log-Rank p = 0.002). Intensive postoperative BS was an independent prognostic factor for both OS (adjusted HR 0.77, 95%CI 0.64, 0.93, adjusted p = 0.006) and OSABM (adjusted HR 0.71, 95%CI 0.60, 0.86, adjusted p < 0.001). The prognostic value of intensive postoperative BS was consistently favorable for OS among clinical high-risk patients, including those with ages younger than 50, stage II, histology grade G3 and ER-Her2- subtype. This multicenter real-world study showed that intensive postoperative BS screening improved survival for BC patients with BM and should probably be recommended for postoperative surveillance, especially for patients at clinical high-risk.

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The Reality in the Surveillance of Breast Cancer Survivors—Results of a Patient Survey

Cited by 4 publications

References 23 publications

The reality in the follow-up of breast cancer survivors: survey of Korean Breast Cancer Society

The reality in the follow-up of breast cancer survivors: survey of Korean Breast Cancer Society

AHNS Series-Do you know your guidelines? Guideline recommended follow-up and surveillance of head and neck cancer survivors

Survival in Breast Cancer Patients with Bone Metastasis: A Multicenter Real-World Study on the Prognostic Impact of Intensive Postoperative Bone Scan after Initial Diagnosis of Breast Cancer (CSBrS-023)

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