Abstract P1-09-19: Patient's views of follow-up after treatment for breast cancer. A comparison of two approaches
Authors: Muktar Samantha T , Thiruchelvam Paul TR , Hadjiminas Dimitri 
Published: May 2015

Background: Routine follow up of patients' post treatment of breast cancer is standard practice in most countries. Follow up involves regularly scheduled clinical appointments with the aim of detecting early breast cancer recurrence and provision of psychological support to the patient. In the United Kingdom, financial constraint has led individual hospital trusts to revaluate the need for lengthy follow up schedules. Development of novel, less time intensive follow-up services, such as ‘open access follow up’ favour a more patient-led approach.

Aim: To assess patients' views on breast cancer follow up, as well as the effect on patient satisfaction of transferring current clinical follow up to an 'open access follow up'.

Method: We report the patients’ views on the basis of pooled data of a detailed survey performed in a large Breast Cancer Centre. All patients receiving regular clinical follow up care over a 6-month period were invited to participate in this prospective study. Patients were provided with a flow-chart, illustrating the current follow up, as well as a proposed ‘open access follow up’ process.

Results: Between November 2013 and April 2014, 304 patients were recruited into the study. 39% of patients were within the first year of their diagnosis with 18% more than 3 years into their follow up. Caucasian women made up the majority of our population group (81%), with 7% Indo-Asian, and 7% Afro-Caribbean.

The main expectation from follow up was surveillance for early detection of recurrence as expressed by 92% and anxiety of treatment side effects. 93% were satisfied with the current follow up they were receiving (satisfaction scores 7-10) and of those, 84% would choose to continue current follow up rather than move toward an ‘open access’ approach.

92% of patients favoured current clinical follow up over ‘open access follow up’, with 66% highlighting ‘open access follow up’ as an ineffective method of follow up. In stark contrast, 94% of patients reported current clinical led follow up to be effective. 91% of patients requested their follow up to be led by a breast surgeon and oncologist, rather than their primary care physician or community nurse. Interestingly, no significant correlation was established between age, ethnic background, distance from hospital and time from diagnosis with the type of follow up preferred.

Conclusion: Following treatment for breast cancer, patients prefer a more regular clinician-led service to a patient-led ‘open access follow up’ process. This may be explained by the observation that patients seek the reassurance of regular clinical review to identify recurrence early, however the psychological support of a clinical consultation cannot be underestimated. It may be inferred that patients who are satisfied in the follow up they were currently receiving are more likely to appreciate the current follow up system rather than moving to an ‘open access' approach. Further study is warranted which investigates the impact of intensified surveillance on survival based on identification of recurrence and to repeat this study to seek consistency of opinion.

Citation Format: Samantha T Muktar, Paul TR Thiruchelvam, Dimitri Hadjiminas. Patient's views of follow-up after treatment for breast cancer. A comparison of two approaches [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-19.