The effectiveness of personalised surveillance and aftercare in breast cancer follow-up: a systematic review

Maaren, Marissa van; Hoeve, J. van; Poorthuis, J.; Korevaar, JC; Drossaert, Constance H.C.; Siesling, Sabine

doi:10.1016/s0959-8049(22)01372-7

Cited by 1 publication

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“…Tis observation fuels the debate about the scope and risk-adapted intensity of oncological follow-up, which, in the UK, for example, includes at least one annual mammography and regular visits with physical examination and medical history [3] but, in some other countries, also includes even denser follow-up schedules with laboratory tests (e.g., tumour markers). On the other hand, there is a lack of evidence on the efectiveness of personalisation, as reported by van Maaren et al [4]: her review shows that existing interventions to personalise follow-up are scarce (especially for surveillance), vary widely, are not structurally embedded in clinical practice, and do not provide clear evidence of their efectiveness. Against this background, the results of the planned prospective Dutch trial on this topic are awaited with interest.…”

Section: Introductionmentioning

confidence: 99%

Determining the Appropriateness and Acceptability of a Reduced Postradiotherapy Surveillance Practice in Breast Cancer Patients: Results of a Longitudinal Observational Study

Holtgrave,

Knöchelmann,

Christiansen

et al. 2024

European Journal of Cancer Care

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Postradiotherapy surveillance, which aims to detect and treat radiation injury, is important from the patient’s perspective, but also from the radiation oncologist’s perspective. Unfortunately, patient nonattendance increases over the course of five years. The aim of the study was to investigate the appropriateness and acceptability of reduced versus usual (conventional) postradiotherapy surveillance in breast cancer patients. A total of 192 consecutive patients with curatively irradiated breast cancer from two selected treatment years were included in our study, of whom 65 were offered six (after three months, 12 months, 24 months, 36 months, 48 months, and 60 months) and 127 were offered four follow-up appointments (after three months, 12 months, 36 months, and 60 months). Their patient-, tumour- and treatment-related characteristics were analysed, as well as follow-up events and attendance rates. The reduced four-meeting surveillance practice shows similar results to the traditional six-meeting practice in terms of appropriateness and acceptability, with significantly higher attendance rates at 36 and 60 months (p=0.014 and 0.013, respectively) when the individual moments are compared on a one-to-one basis. The patient-, tumour-, and treatment-related variables examined did not show an effect on the attendance rate. There was also no significant difference between the two cohorts in the detection of follow-up events (such as recurrence) and late radiation effects. In conclusion, this retrospective study provides scientific support for the trend towards a risk-adjusted, reduced surveillance practice in radiation oncology. In particular, four postradiotherapy follow-up visits seem to be appropriate and accepted in breast cancer patients after curative postoperative breast irradiation. This reduced postradiotherapy surveillance practice has the advantage of saving time for the patient and resources for the healthcare system without compromising quality; it could also improve patient participation. We, therefore, recommend it as an appropriate standard for breast cancer patients.

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Section: Introductionmentioning

confidence: 99%