American society of clinical oncology-recommended surveillance and physician specialty among long-term breast cancer survivors

Kerry Hollowell, Courtney L. Olmsted, Anne S. Richardson, H. Keith Pittman, Lisa Bellin, Lorraine Tafra, Kathryn M. Verbanac

Research output: Contribution to journalArticle

Abstract

BACKGROUND: It is unclear whether it is appropriate to transfer the follow-up care of breast cancer (BrCa) survivors from cancer specialists to primary care physicians (PCPs). This contemporary study compared physician specialty and documented the long-term surveillance of survivors who underwent surgery at an American academic center. METHODS: Women in this institutional review board-approved study underwent breast surgery between 1996 and 2006. Data were collected for 270 patients with stage I to III BrCa (mean follow-up, 6 years). Charts were reviewed based on American Society of Clinical Oncology (ASCO) guidelines for recommended surveillance frequency and care. RESULTS: The majority of patients (90%; n = 242) were followed by specialists with 10% (n = 28) followed by PCPs. Patients with advanced disease and a greater risk of disease recurrence more often received specialist care. Patients followed by specialists were more often seen at ASCO-recommended intervals (eg, 89% vs 69% of patients followed by a PCP at follow-up Year 6; P < .01); however, many patients were followed inconsistently. Breast disease was often not the focus of PCP visits or mentioned in clinic notes (18% patients). Women seen by specialists were more likely to have documented clinical examinations of the breast (93% vs 44% at Year 6), axilla (94% vs 52%), or annual mammograms (74% vs 48%; P = .001-.02). CONCLUSIONS: Consistent compliance with surveillance guidelines and chart documentation needs improvement among all providers; however, specialists more consistently met ASCO guidelines. If transfer of care to a PCP occurs, it should be formalized and include follow-up recommendations and defined physician responsibilities. Providers and patients should be educated regarding surveillance care and current guidelines incorporated into standard clinical practice.

Original languageEnglish (US)
Pages (from-to)2090-2098
Number of pages9
JournalCancer
Volume116
Issue number9
DOIs
StatePublished - May 1 2010

Keywords

  • American society of clinical oncology (ASCO)
  • Breast cancer guidelines
  • Breast cancer surveillance
  • Follow-up breast cancer
  • Follow-up guidelines
  • Long-term surveillance
  • Primary care physician
  • Surveillance mammography

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Hollowell, K., Olmsted, C. L., Richardson, A. S., Pittman, H. K., Bellin, L., Tafra, L., & Verbanac, K. M. (2010). American society of clinical oncology-recommended surveillance and physician specialty among long-term breast cancer survivors. Cancer, 116(9), 2090-2098. https://doi.org/10.1002/cncr.25038