[The ideal follow-up after breast cancer operation]

With the increase in breast cancer patients in Japan, therapy for breast cancer has progressed with evidence-based medicine (EBM), and most of it has shifted to outpatient clinics (OPC) except for surgery. With the specialization of surgical techniques and pharmacological treatments, i. e. sentinel node biopsy and advanced medical treatment, many patients now visit specialized cancer clinics, and the congestion has resulted in difficulty in follow-up after surgery, and the reconsideration of how to follow-up is under way. Although the clinical guideline issued by the Japanese Breast Cancer Society recommends performing a careful history, physical examination and annual mammography, each clinic has its own follow-up program with additional modalities different approaches in EBM. Here we investigate the recommendations of the clinical guideline, how they discuss evidence, and we attempt to pinpoint the problems when used at the daily clinical level while considering the characteristics of current breast cancer practice. Then, we considered the specific characteristics of breast cancer revealed by meta-analyses, the effect of long-term adjuvant endocrine therapy after surgery, and reflecting the patient's intent in follow-up in order to conduct an ideal follow-up with a view to cooperation between cancer specialized hospitals and community clinics.