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    Long-term follow-up of women with breast cancer: rationale for policy change.

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    Authors
    McCarthy, T
    Mullen, L
    Murphy, H
    Carey, D
    Laffoy, M
    Affiliation
    National Cancer Control Programme, Kings Inns House, 200 Parnell St, Dublin, 1, Ireland, triona.mccarthy@cancercontrol.ie.
    Issue Date
    2014-10-01
    Keywords
    BREAST CANCER
    WOMEN
    HEALTH POLICY
    
    Metadata
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    Citation
    Long-term follow-up of women with breast cancer: rationale for policy change. 2014: Ir J Med Sci
    Publisher
    Springer
    Journal
    Irish journal of medical science
    URI
    http://hdl.handle.net/10147/332131
    DOI
    10.1007/s11845-014-1202-4
    PubMed ID
    25271102
    Additional Links
    http://link.springer.com/article/10.1007/s11845-014-1202-4/fulltext.html
    Abstract
    The number of breast cancer survivors in our ageing population continues to rise. Policy makers internationally are seeking to identify alternatives to follow-up care in an acute setting.
    The National Cancer Control Programme set out to develop a new policy for long-term follow-up of breast cancer survivors in Ireland.
    Policy development was informed by analysis of current attendances at breast surgical clinics for routine follow-up, extraction of the necessary components of follow-up from international guidelines and focus group research with Irish patients.
    Intensive follow-up investigations, other than mammography, do not confer additional survival benefit or improved quality of life. Provision of routine follow-up care of breast cancer survivors by GPs has been shown to be equivalent to follow-up by specialist clinics, in terms of clinical outcomes, patient quality of life and patient satisfaction. In Ireland, routine follow-up accounted for 15.4 % (95 % CI: 13.8-17.0 %) of clinic appointments. A third were at least 5 years post-operative. Women highlighted issues such as attachment to specialist services, importance of communication and need for clarity as to where responsibility of care lies. Reassurance, confidence in the primary care practitioner, and coordination of multiple appointments were also identified as important issues.
    A significant proportion of breast cancer survivors attending hospital surgical clinics for long-term follow-up could be safely discharged at 5 years, with the hospital maintaining responsibility for annual mammography. Successful implementation will depend on informed patients, clinicians' acceptance and communication between primary and secondary care.
    Item Type
    Article In Press
    Language
    en
    ISSN
    1863-4362
    ae974a485f413a2113503eed53cd6c53
    10.1007/s11845-014-1202-4
    Scopus Count
    Collections
    Cancer (incl. National Cancer Control Programme & Cancer Screening Service)

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