Perceptions of follow-up care in women with breast cancer

One hundred one patients with breast cancer, 48 localized and 53 metastatic, were questioned about their perceptions of follow-up examinations. Patients with metastatic disease preferred more frequent follow-up. Most indicated that they wanted their physicians to ask them about pain and nutritional status at each follow-up visit and were aware of the tests they had received. Only a third of the patients recognized the value of the history in detecting recurrence, and two-thirds felt that the physical examination was helpful. Laboratory tests and imaging procedures were rated higher than the history in detecting recurrence. Most patients were unaware of the implications of a normal procedure or test and perceived "normal" as meaning an absence of cancer cells in the organ evaluated. Knowledge of the value and limitations of testing was not related to educational level or disease stage. Patients need to be educated about the effectiveness of follow-up examination. Greater emphasis should be placed on the history and physical examination, and the limitations of more costly laboratory and imaging procedures should be explained carefully.