University of Twente Student Theses


Personalisation of follow-up care in women treated for breast cancer: a retrospective cohort study

Vorm, A.I. van der (2016) Personalisation of follow-up care in women treated for breast cancer: a retrospective cohort study.

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Abstract:Purpose Breast cancer follow-up is intended to be more personalized in the Netherlands with respect to detection of loco regional recurrences according to the new guideline. In contrast, the previous guideline recommended the same follow-up for all patients despite the variance in risk of recurrences for individuals. To give insight in the personalisation of follow-up care, we studied whether follow-up practice differs between patients diagnosed before and after implementation of a new, more personalized intended guideline for arrangement of follow-up, whether the follow-up practices differs from the old and current guidelines and whether individual follow-up care plans are compiled. Methods A retrospective cohort study was performed reviewing 250 patient charts of curatively treated patients for primary invasive breast cancer diagnosed in 2010, 2012 or 2013 in five hospitals in the Netherlands. Patients were selected from the Netherlands cancer registry. Data about follow-up visits with the purpose of detecting of loco-regional recurrences was extracted from patient charts. The number of follow-up visits were tested for differences and Poisson regression was used to determine whether the amount of visits depended on known risk factors for recurrence. Results Patients of both cohorts received more follow-up visits than recommended by the different guidelines. The total number of follow-up visits increased when a radiotherapist was involved, the patient was younger and had a lower tumour stage. An underuse of mammography was found. The follow-up plans that were found showed no evidence of personalisation based on risk of recurrence. Conclusions Despite providing different recommendations, follow-up of patients diagnosed with breast cancer before and after publication of the 2012 guideline was almost similar concerning the visits with the purpose of detection of LRRs, during the first three years of follow-up. Influence of age, tumour stage and receiving radiotherapy on the number of follow-up visits suggests some personalisation of follow-up.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Health Sciences MSc (66851)
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