Abstract P4-11-31: Health care professionals’ perspectives on less intensive post-treatment surveillance after breast cancer for women with low risks for recurrences
Authors: Ankersmid Jet W. , Drossaert Constance H.C. , van Uden-Kraan Cornelia F. , Strobbe Luc J.A. , Siesling Sabine 
Published: March 2022

Abstract
Introduction: Whereas the treatment for breast cancer is highly personalized, surveillance remains one-size-fits-all: annual imaging and physical examination for at least five years after treatment. The INFLUENCE-nomogram is a prognostic model to estimate the five-year risk for locoregional recurrences (LRRs) and second primary tumors (SPs) after breast cancer. These risks can help identify patients for which less intensive post-treatment surveillance is sufficient. However, health care professionals (HCPs) seem hesitant about less intensive surveillance for women with a low risk for recurrences. Therefore, the aim of this study was to explore benefits, barriers and preconditions for less intensive post-treatment surveillance for women at low risk for recurrences after breast cancer as perceived by HCPs.Methods: We conducted semi-structured interviews with 21 HCPs that provide breast cancer care in seven Dutch teaching hospitals (Santeon hospital group). Analysis was performed using the framework analysis method, which is a combination between inductive and deductive approaches.Results: HCPs were predominantly positive about less intensive surveillance for women with a low risk for recurrences. Most mentioned perceived advantages were a lower burden for patients and the healthcare system, cost reduction for patients and society, and that patients can be reminded less of being a patient and can continue their lives. Perceived disadvantages were the possibility of missing early recurrences, fear and insecurity among patients and less opportunities to monitor and address needs for aftercare. Mentioned preconditions were clearly defined surveillance schedules based on risk categories, easy access to HCPs in case of worries, and information provision and communication for patients and HCPs containing evidence on surveillance schedules based on risk categories. According to the HCPs, information provision should be improved on the aims, options for (duration, frequency, imaging modalities), and advantages and disadvantages of post-treatment surveillance. Shared decision making, between the patient and HCP on the organization of post-treatment surveillance in breast cancer, was also mentioned in this context.Conclusion: HCPs are open to less intensive surveillance for women with a low risk for recurrences. Certain preconditions should, however, be fulfilled first such as better information provision and the development of risk-based surveillance schedules based on risks for recurrences.
Citation Format: Jet W. Ankersmid, Constance H.C. Drossaert, Cornelia F. van Uden-Kraan, Luc J.A. Strobbe, Sabine Siesling. Health care professionals’ perspectives on less intensive post-treatment surveillance after breast cancer for women with low risks for recurrences [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-31.