Breast cancer "tailored follow-up" in Italian oncology units: a web-based survey

PLoS One. 2014 Apr 8;9(4):e94063. doi: 10.1371/journal.pone.0094063. eCollection 2014.

Abstract

Purpose: Breast cancer follow-up procedures after primary treatment are still a controversial issue. Aim of this study was to investigate, through a web-based survey, surveillance methodologies selected by Italian oncologists in everyday clinical practice.

Methods: Referents of Italian medical oncology units were invited to participate to the study via e-mail through the SurveyMonkey website. Participants were asked how, in their institution, exams of disease staging and follow-up are planned in asymptomatic women and if surveillance continues beyond the 5th year.

Results: Between February and May 2013, 125 out of 233 (53.6%) invited referents of Italian medical oncology units agreed to participate in the survey. Ninety-seven (77.6%) referents state that modalities of breast cancer follow-up are planned according to the risk of disease progression at diagnosis and only 12 (9.6%) oncology units apply the minimal follow-up procedures according to international guidelines. Minimal follow-up is never applied in high risk asymptomatic women. Ninety-eight (78.4%) oncology units continue follow-up in all patients beyond 5 years.

Conclusions: Our survey shows that 90.4% of participating Italian oncology units declare they do not apply the minimal breast cancer follow-up procedures after primary treatment in asymptomatic women, as suggested by national and international guidelines. Interestingly, about 80.0% of interviewed referents performs the so called "tailored follow-up", high intensity for high risk, low intensity for low risk patients. There is an urgent need of randomized clinical trials able to determine the effectiveness of risk-based follow-up modalities, their ideal frequency and persistence in time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / therapy*
  • Female
  • Follow-Up Studies
  • Guideline Adherence*
  • Health Care Surveys
  • Humans
  • Italy
  • Medical Oncology / methods*
  • Middle Aged
  • Secondary Prevention

Grants and funding

Supported by the Consorzio Interuniversitario Nazionale per Bio-Oncologia (CINBO) and by the Gruppo Interdisciplinare Cure Oncologiche (GICO), ASL Lanciano-Vasto-Chieti, Italy. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.