POPULARITY OF LESS FREQUENT FOLLOW-UP FOR BREAST-CANCER IN RANDOMIZEDSTUDY - INITIAL FINDINGS FROM THE HOTLINE STUDY

Objective: To compare the experiences of patients with breast cancer w ho were conventionally monitored with those in whom routine follow up was restricted to the time of mammography. Design: Randomisation to co nventional schedule of clinic visits or to visits only after mammograp hy, Both cohorts received identical mammography and were invited to te lephone for immediate appointments if they detected symptoms. Setting: Combined breast clinic Chelsea and Westminster Hospital. Subjects: 21 1 eligible outpatients with a history of breast cancer. Main outcome m easures: Acceptability of randomisation, interim use of telephone and general practitioner, satisfaction with allocation to follow up. Resul ts: Of 211 eligible patients, 196 (93%) opted for randomisation in the study, Of these, 55 were under 50 years, 78 were diagnosed fewer than five years before, 90 had stage T2-4 tumours, and 71 had involved axi llary nodes, Patients who did not participate were more likely to be u nder 50 years, to be two to five years after diagnosis, and to have ha d aggressive primary disease, Twice as many patients in both groups ex pressed a preference for reducing rather than increasing follow up, No increased use of local practitioner services or telephone triage was apparent in the cohort randomised to less frequent follow up by specia lists. Conclusions: Reducing the frequency of routine follow up has so far proved popular among patients with breast cancer at standard risk in this cohort. A multicentre study is needed to determine the effect iveness and cost-effectiveness of routine follow up with respect to di sease outcomes.