( Authors of the cancer journal Annals ...)Breast Cancer Patients Follow-up Devalued,Health

Authors of the cancer journal, Annals of Oncology, (Thursday 24 May). [1] have published that follow-up of breast cancer patients after their initial treatment is becoming "devalued and deregulated. "

They also suggest that large financial savings are possible if follow ups could be well designed and coordinated and community-based teams of doctors and nurses are better used. This would enable patient access to new and expensive adjuvant drugs (such as aromatase inhibitors). It will also help them to see relevant hospital specialists more quickly.

Peter Donnelly, the lead author of the study, is a consultant surgeon at Torbay Hospital, UK, and a member of the Breast Cancer Studies Group of the National Cancer Research Institute (NCRI), which initiated the study in conjunction with groups involved in the development of primary care. He said: "While this research looked at what is happening in the UK, its conclusions that good follow-up is important, is more complex than previously thought and requires careful planning and co-ordination between hospitals and community-based healthcare teams, are applicable in many other countries."

The researchers found that only nine percent of cancer specialists discharged patients according to protocols that conformed with guidelines from NICE (the UKs National Institute for Health and Clinical Excellence), the duration of follow-up by the specialists ranged between a year to more than ten years in some cases, and the frequency of mammographies for invasive and non-invasive disease varied between one and three years.

Specialists cited lack of confidence in general practitioners experience and training in oncology and loss of data on patient outcome as their main concerns about discharging patients into the care of the local doctors and nurses.

The researchers sent a questionnaire to 562 cancer specialists in the UK, asking them about discharging patients and ho
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