A preliminary study of patients' perceptions of routine follow-up after treatment for breast cancer

Early detection and longer survival have led to increasing numbers of patients requiring follow-up after treatment for breast cancer, yet there is little consensus as to how this should be achieved. Breast cancer patients have needs that change over time but the current system of follow-up is traditionally routinized and lacks an individualized approach. This preliminary study was designed to ascertain patients' perceptions of routine follow-up care after completion of treatment for breast cancer. A cross-sectional survey of a stratified systematic sample of patients was utilized. Data were collected using semi-structured, taped interviews. The tapes were inductively analysed and coded to ascertain predominant themes. Twenty-four patients were recruited. Analysis indicated that follow-up examinations were hurried (18 patients), investigations were not reassuring (11) and that the lack of continuity was unacceptably poor (22). Many patients (19) felt uncomfortable expressing emotional concerns or asking questions. The majority (18) stated that they would prefer to receive all or part of their follow-up from a breast care nurse. These findings have implications for service provision in terms of quality and cost-effectiveness. On the basis of these results a patient-focused, nurse-led intervention is being evaluated against traditional medical follow-up for patients with breast cancer.