The Reality in the Surveillance of Breast Cancer Survivors-Results of a Patient Survey

Stemmler Hans-Joachim1, Lässig Dorit1, Stieber Petra2, Bauerfeind Ingo3, Kahlert Steffen3, Fasching Peter Alexander4, Beckmann Matthias Wilhelm4, Glattes Margrit5, Goldmann-Posch Ursula6, Hoffmann Verena,1 Untch Michael7 and Heinemann Volker1 1Department of Hematology and Oncology. 2Department of clinical Chemistry. 3Department of Gynaecology and Obstetrics. 1-3Ludwig-Maximilians University of Munich, Klinikum Großhadern, Munich, Germany. 4Department of Gynaecology and Obstetrics, University of Erlangen, Germany. 5AOK Rheinland/Hamburg, Germany. 6Mamazone e.V., Augsburg, Germany. 7Department of Gynaecology and Obstetrics, Helios Klinikum, Berlin-Buch, Germany. Abstract Background: International guidelines for the surveillance of breast cancer patients recommend a minimized clinical follow-up including routine history and physical examination and regularly scheduled mammograms. However, the abandonment of scheduled follow-up examinations in breast cancer survivors remains a contradiction to established follow-up guidelines for other solid tumours. Patients and Methods: We report the patients' view on the basis of a survey performed in two separate geographical areas in Germany. The questionnaires were sent out to 2.658 patients with a history of breast cancer. Results: A total of 801 patients (30.1%) responded to the questionnaire. The results of the survey can be summarized in two major categories: First, necessity for surveillance was affi rmed by a majority (>95%), and 47.8% of the organized patients answered that there was a need for more intensive diagnostic effort during follow-up. The main expectation from an intensified follow-up was the increased feeling of security as expressed by >80% of the women. Second, the present survey indicates that most of the regularly scheduled follow-up visits were expanded using extensive laboratory and imaging procedures exceeding the quantity of examinations recommended in the present follow-up guidelines. Conclusion: Despite the fact that only one third of the patients responded to the questionnaire, the survey indicates that a majority of physicians who treated these patients still do not accept the present follow-up guidelines. To some extent this may be explained by the observation that patients and possibly also their doctors trust that intensified follow-up increases diagnostic security and survival. Since considerable changes in the treatment options of breast cancer have been made during the last decades a n