WHO PROVIDES FOLLOW-UP CARE FOR PATIENTS WITH EARLY BREAST-CANCER

OBJECTIVE To assess how often family physicians are involved in posttr eatment care of their stage I breast cancer patients and to identify f actors associated with family physicians providing follow-up care. DES IGN A retrospective cohort study with a 5-year follow up by chart revi ew. PARTICIPANTS All cases of breast cancer seen at the London Regiona l Cancer Centre between 1982 and 1987 were reviewed to identify 183 st age I cancer patients alive at 5 years. MAIN OUTCOME MEASURES Whether a physician (other than an oncologist) was involved in the follow-up c are of patients, and whether the physician was a family physician or,a surgeon. RESULTS Follow-up care during the 5-year postoperative perio d was provided in most cases by oncologists alone (66.7%); family phys icians and surgeons were involved in 17.5% and 15.8% of cases, respect ively. Surgeons became involved in follow-up care much earlier(l2 mont hs) than family physicians did (23 months) (P = 0.01) and were more li kely to provide care for patients who received radiation treatment (P = 0.04) and for patients who lived in London (P = 0.004). Most maligna nt breast lesions (77.5%) were discovered by patients themselves (P = 0.0001). CONCLUSIONS Currently family physicians are infrequently invo lved in follow-up care of their patients with early breast cancer.