Which organizations issued guidelines on follow-up care for breast cancer survivors?

Updated: Feb 04, 2021
  • Author: Pavani Chalasani, MD, MPH; Chief Editor: John V Kiluk, MD, FACS  more...
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Answer

The National Comprehensive Cancer Network (NCCN) [75]  and the American Cancer Society/American Society of Clinical Oncology (ACS/ASCO) [191]  have issued guidelines on followup care for breast cancer survivors. The guidelines differ principally in the timing of care. See the table below.

Table Follow-up Recommendations for Breast Cancer Survivors (Open Table in a new window)

 

NCCN

ACS/ASCO

History and physical examination

Year 1, every 3-4 mo

Year 2, every 4 mo

Year 3-5, every 6 mo

Year 6+, annually

Year 1-3, every 3-6 mo

Year 4-5, every 6-12 mo

Year 6+, annually

Signs of recurrance

No recommendation

Educated and counseled about signs and symptoms 

Mammography

6 mo after post-BCS radiation therapy

Annually thereafter

Annually 

MRI No recommendation

Not recommended for routine screening unless patient

meets high-risk criteria for increased surveillance

Pelvic examination

Annually, for women on tamoxifen

Annual exam if uterus present

No recommendation

Routine blood tests

Not recommended

Not recommended

Imaging studies

Not recommended

Not recommended

Tumor marker testing

Not recommended

No recommendation

Mammography guidelines for older survivors of breast cancer, developed by a nationwide multidisciplinary expert panel and the International Society of Geriatric Oncology, include the following recommendations [192] :

  • Discontinue mammography in patients aged 75 or older whose life expectancy is under 5 years.
  • Consider discontinuing mammography in patients whose life expectancy is 5 to 10 years.
  • Continue annual or biennial mammography in those whose life expectancy exceeds 10 years.
  • For women age 85 and older (whose life expectancy is often under 5 years), discontinue mammography unless the patient is in extraordinary health and has a strong preference to continue testing.

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