OBJECTIVE: To assist @entity1 and their physicians in arriving at the most effective follow-up strategy after treatment for @entity0 . OUTCOMES: Survival, metastasis-free survival, local recurrence, quality of life. EVIDENCE: Evidence was based on a literature review using MEDLINE for the years 1991 to 1996, references cited in reviews and consensus conference proceedings. RECOMMENDATIONS: All @entity1 who have completed their primary treatment for @entity0 should have regular follow-up surveillance. The frequency of follow-up visits should be adjusted according to individual @entity1 's needs. The following issues and schedule should be considered: (a) The need to discuss and manage early side effects of therapy, plan a follow-up program and provide general support. (This visit is usually scheduled 4 to 6 weeks after therapy.) (b) The need to establish a post-treatment baseline, detect early recurrences and teach breast self-examination. (This visit is usually 4 to 6 months after therapy.) (c) The need for regular physical and mammographic examination to detect potentially curable disease. (These examinations should be at approximately 1-year intervals indefinitely thereafter.) (d) The need to provide support and counselling may require additional visits for some @entity1 , particularly for the first few years. (e) If metastases develop, the frequency of visits must be determined by the symptoms, course of disease and need for further treatment. All visits should include a medical history. For @entity1 who are taking @entity440 , it is important to ask about @entity3556 . Physical examination should include both breasts, regional lymph nodes, chest wall and abdomen. The arms should be examined for @entity4269 . Annual visits should include mammographic examination. Routine laboratory and radiographic investigations should not be carried out for the purpose of detecting distant metastases. @entity1 should be encouraged to report new, persistent symptoms promptly, without waiting for the next scheduled appointment. Breast self-examination should be taught to those @entity1 who wish to carry it out. Psychosocial support should be encouraged and facilitated. Participation in clinical trials should be facilitated and encouraged. The responsibility for follow-up care should be formally allocated to a single physician, with the @entity1 participating as much as possible. The @entity1 should always be fully informed of these arrangements. Communication between all members of the therapeutic team must be ensured to avoid duplication of visits and tests. VALIDATION: Successive reviews and revisions of this document were carried out by a writing committee, expert primary reviewers, secondary reviewers from across Canada, and by the Steering Committee. This final version reflects a substantial consensus of all individuals involved. This guideline has been reviewed and approved by the Canadian Association of Radiation Oncologists.

Follow-up after treatment for XXXX . The Steering Committee on Clinical Practice Guidelines for the Care and Treatment of @entity0 .

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients', 'patient'] @entity3556 :: ('MESH:D014592', 'Disease') :: ['vaginal bleeding'] @entity440 :: ('MESH:D013629', 'Chemical') :: ['tamoxifen'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity4269 :: ('MESH:D008209', 'Disease') :: ['lymphedema']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
