Follow-up of breast cancer patients after their initial treatment is becoming "devalued and deregulated", according to new research published online in the cancer journal, Annals of Oncology, today (Thursday 24 May). 
Yet, the authors say that if follow-up was well designed, co-ordinated and made better use of community-based teams of doctors and nurses, then health authorities could make large financial savings that could be put towards giving patients better access to new and expensive adjuvant drugs (such as aromatase inhibitors), as well as enabling them to see relevant hospital specialists more quickly. Cancer specialists would gain more time to concentrate on patients with more complex needs, while patients would gain better care and psychological support in their local communities.
Peter Donnelly, the lead author of the study, is a consultant surgeon at Torbay Hospital, UK, and a member of the Breast Cancer Studies Group of the National Cancer Research Institute (NCRI), which initiated the study in conjunction with groups involved in the development of primary care. He said: "While this research looked at what is happening in the UK, its conclusions that good follow-up is important, is more complex than previously thought and requires careful planning and co-ordination between hospitals and community-based healthcare teams, are applicable in many other countries."
The researchers found that only nine percent of cancer specialists discharged patients according to protocols that conformed with guidelines from NICE (the UKs National Institute for Health and Clinical Excellence), the duration of follow-up by the specialists ranged between a year to more than ten years in some cases, and the frequency of mammographies for invasive and non-invasive disease varied between one and three years.
Specialists cited lack of confidence in general practitioners experience and training in oncology and loss of data on patient outc
Contact: Emma Mason
European Society for Medical Oncology