Postoperative follow‐up of patients with early breast cancer. Patterns of care among clinical oncologists and a review of the literature

Eighty clinical oncologists in the southeastern United States were surveyed to determine their strategies for follow‐up care after primary treatment of early‐stage breast cancer. The frequency of use of the history and physical examination, complete blood count, liver function tests, carcinoembryonic antigen levels, chest x‐ray, skeletal survey, bone scan, liver scan, and mammogram for observing hypothetical low‐ and high‐risk patients was assessed. Yearly mammograms were recommended by more than 95% of respondents. History and physical examination were the modalities used most often, whereas periodic bone and liver scans were used only in a minority of patients. A review of the literature supported the strategy of the respondents in this survey and further underscored the cost‐effectiveness of the history and physical examination in detecting recurrence during follow‐up. Based on this survey and supporting literature, recommendations for reasonable yet cost‐conscious follow‐up are presented.