Effectiveness of long-term follow-up of breast cancer

PhD ceremony: Ms. W. Lu, 16.15 uur, Aula Academiegebouw, Broerstraat 5, Groningen

Dissertation: Effectiveness of long-term follow-up of breast cancer

Promotor(s): prof. G.H. de Bock, prof. T. Wiggers

Faculty: Medical Sciences

Breast cancer survivors live with an increased risk for recurrences and second cancers. Several international practice guidelines recommend that breast cancer survivors should receive routine follow-up care. In this thesis, a meta-analysis indicated that early detection of breast cancer recurrences during follow-up gave a significantly better survival as compared to late detected recurrences. However, underutilization of mammography among patients in routine hospital follow-up was still found in 30-40% patients. Mammography is a valuable tool for the early detection of recurrences during hospital follow-up of breast cancer patients and is probably beneficial to survival. There was a trend that the contribution of physical examination was higher in women under 60 years of age in the detection of various recurrences, than in women over 60 years. Routine physical examination may be most valuable for women with a history of breast cancer younger than 60 years. A micro-simulation model supports that decrease of hospital follow-up time, lowering the discharge age, and stopping yearly physical examination, will lead to a significant reduction in costs while maintaining the same clinical effects. Most patients (96%) had less follow up visits than recommended. Further investigation of the potential factors related to low compliance is already under way.