Within the 5 years following a diagnosis for stage I or II breast cancer, 21% of patients stop seeing physicians for follow-up care, according to a study in the Journal of Oncology Practice.
Breast cancer is the second most common form of cancer for women in the U.S., with about 12% of women developing the condition, according to the American Cancer Society. Breast cancer has a high level of lethality, and only lung cancer kills more women annually.
Study co-author Dawn Hershman, MD, of Columbia University Medical Center in New York, , explained why follow-up care is crucial for recovery.
“It is important for patients to know that, during follow-up appointments, they are being evaluated for recurrence, evaluated for early detection of new primary tumors, and to make sure they are up-to-date with other cancer prevention activities,” she said. “In addition, information is rapidly changing, so keeping up with the oncologist is important to make sure the care is current.”
Hershman and colleagues examined data from more than 30,000 patients, ages ≥65, and reported several key points:
- In year 1 after diagnosis, 85.8% of patients saw a medical oncologist and 71.9% saw a radiation oncologist in addition to a surgeon
- Two-thirds of the patients visited all three kinds of providers in the first year after diagnosis
- In the 5 years after diagnosis, 21% of patients stopped follow-up visits
Factors predictive of discontinued follow-up care included older age, single relationship status, patients with low-grade tumors, and patients with hormone receptor-negative breast cancer.
Surgeons and oncology specialists can take steps to increase follow-up care for breast cancer, the researchers noted.
“Coordination of follow-up care between oncology specialists and other providers may reduce discontinuation rates as well as the redundancy of visits, thereby increasing clinical efficiency. Identifying patients who are at risk for early discontinuation of follow-up will eventually allow for the promotion of public health initiatives to improve access to care,” they wrote.
Hormone therapy should be a focal point of public health efforts, Hershman said. “The most important thing we do during follow-up is to make sure women on hormone therapy stay on their hormone therapy. Making sure these treatments are available to everyone is an important public health initiative.”
Educating breast cancer patients about the seriousness of follow-up care is essential, she said. “As a provider, it is hard to know when patients stop following up. Sometimes, patients move or change providers. Patients need to be active in making sure they follow with at least one provider.”
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