Breast cancer survivorship care plans: what are they covering and how well do they align with national guidelines?

Youngjee Choi, Katherine C. Smith, Aishwarya Shukla, Amanda L. Blackford, Antonio C. Wolff, Elissa Thorner, Kimberly S. Peairs, Walid El Ayass, Patricia Njoku, Katie Papathakis, Carol D. Riley, Nelli Zafman, Fariba Asrari, Melissa Camp, Jean L. Wright, Nancy J. Mayonado, Sharon M. White, Claire F. Snyder

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Survivorship care plans (SCPs) provide key information about cancer treatment history and follow-up recommendations. We describe the completeness of breast cancer SCPs and evaluate guideline concordance of follow-up recommendations. Methods: We analyzed 149 breast cancer SCPs from two sites, abstracting demographics, cancer/treatment details, surveillance plans, and health promotion advice. SCP recommendations and provided information were compared to American Cancer Society/American Society of Clinical Oncology and National Comprehensive Cancer Network guidelines. Results: SCP information provided in > 90% of the plans included patient age; relevant providers; cancer stage; treatment details; and physical exam, mammogram, and health promotion recommendations. SCP components completed less frequently included post-treatment symptoms/side effects (67%). All SCPs at the community site were uniform but had the potential for oversurveillance if visits occurred every 3 months in years 1–2 or every 6 months in years 3–5 with multiple cancer providers. The academic site recommended three predominant patterns of follow-up: (1) primary care provider every 6–12 months; (2) cancer team every 3–6 months (year 1), every 6–12 months (years 4–5); and (3) alternating oncology providers every 3–6 months (years 1–2) then every 6 months. Compared to guidelines, these patterns recommend under- and oversurveillance at various times. Mammography recommendations showed guideline concordance (annual) for 84%, oversurveillance for 10%, and were incomplete for 6%. SCPs of only 12/79 (15%) women on aromatase inhibitors recommended guideline-concordant bone density testing. Conclusions: SCP content is more complete for demographic and treatment summary information but has follow-up recommendation gaps. Efforts to improve follow-up recommendations are needed.

Original languageEnglish (US)
Pages (from-to)415-424
Number of pages10
JournalBreast Cancer Research and Treatment
Volume179
Issue number2
DOIs
StatePublished - Jan 1 2020

Keywords

  • Breast cancer
  • Cancer survivorship
  • Guideline concordance
  • Survivorship care plan

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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