Patients' beliefs about the aims of breast cancer follow-up: A qualitative study

To explore patients' beliefs about the aims of breast cancer follow-up, and to compare these with the current literature on best practice for survivor care.

We reviewed the literature on breast cancer and interviewed 61 women with a history of early-stage breast cancer. By means of descriptive content analysis with qualitative and quantitative elements, the patients' verbatim responses were thematically and independently analysed by two researchers. Results were compared with current literature and breast cancer guidelines.

When patients were asked to comment on what they thought the aims of breast cancer follow-up were, they most frequently mentioned 'detection of recurrence' and 'receiving reassurance', followed by 'receiving psychological support', and 'collecting data to evaluate care'. Some patients explicitly mentioned 'surveillance for metastatic disease' as an aim of follow-up. However, some patients believed that breast cancer could not recur after 2-5 years of follow-up, and that recurrences could not develop directly after or between follow-up appointments. In relation to follow-up appointments, some patients experienced anxiety, while others felt it made them confront their breast cancer history.

Patients' beliefs are often not in line with guidelines. Educating patients about the aims of follow-up, and the evidence underlying it, might be important, in part to make patients' expectations more realistic.