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Breast Cancer Follow-Up and Surveillance After Primary Treatment: ASCO Guideline Update
Zeina Nahleh1, Catherine M Alfano2, Mark R Somerfield3
1Cleveland Clinic, Weston Florida.
Summary
This guideline provides recommendations for breast cancer follow-up and surveillance after primary treatment. A risk-based approach is advised, emphasizing regular check-ups and mammography for all patients.
Area of Science:
- Oncology
- Clinical Guidelines
- Evidence-Based Medicine
Background:
- Breast cancer survivors require tailored follow-up strategies post-primary treatment.
- Current evidence for optimal surveillance protocols is limited, particularly concerning relapse risk stratification.
Purpose of the Study:
- To develop evidence-based recommendations for breast cancer follow-up and surveillance.
- To guide clinicians in managing patients after primary breast cancer treatment.
Main Methods:
- Systematic literature review and a formal modified Delphi consensus process.
- An Expert Panel convened by the American Society of Clinical Oncology (ASCO) developed the recommendations.
Main Results:
- Limited randomized controlled trials (RCTs) were identified, primarily supporting mammography surveillance.
- Consensus-based recommendations were generated due to a dearth of high-quality evidence for varied follow-up approaches.
- A risk-based approach is recommended, incorporating regular history, physical examination, and mammography.
Conclusions:
- The guideline advocates for a risk-stratified approach to breast cancer surveillance in the adjuvant setting.
- Regular clinical assessments and mammography are recommended; virtual or in-person visits are acceptable.
- Closer surveillance is suggested for high-risk patients, with ongoing updates anticipated as new tools emerge.
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