Medical surveillance after breast cancer diagnosis

Objectives. To characterize the tests ordered for surveillance of breast ca ncer recurrence in the 4 years after breast cancer diagnosis by surgeons, m edical oncologists, and radiation oncologists. RESEARCH DESIGN. 303 stage I or II breast cancer patients age 55-years or o lder and diagnosed at 1 of 5 Boston hospitals. Patient interviews and medic al record abstracts provided the data to characterize patient demographics, the breast cancer stage and its primary therapy, and the surveillance proc edures ordered. RESULTS. 279 of the 303 women had some surveillance testing. Among those wh o received some surveillance, a mean of 22.0 tests were ordered, most by th eir medical oncologists (mean = 14.4), followed by their surgeons (mean = 9 .7) and their radiation oncologists (mean = 5.7). The most common test was a mammogram (mean = 3.9). Women ages 75 to 90 years old were at higher risk for failure to complete four consecutive years of surveillance and for rec eipt of less than guideline surveillance. Younger women, women treated at a breast cancer center with a unified patient chart, and women who worked fu ll or part time were at lower risk for failure to complete 4 years of surve illance. CONCLUSION. Most women in this cohort received some surveillance after comp leting primary therapy for breast cancer. Although no woman's surveillance corresponded exactly to existing guidelines, the oldest women were least li kely to receive guideline surveillance. Surveillance after breast cancer th erefore joins the list of aspects of breast cancer care-breast cancer scree ning, diagnosis, prognostic evaluation, and primary therapy-for which older women receive less than definitive care.