According to Annemieke Witteveen from the University of Twente, the number of follow-up visits after treatment for breast cancer in the Netherlands could be reduced by about 9000 per year. Personalized follow-up reduces the burden on patients, health care providers and to optimize financing.
In the Netherlands, every day diagnosed with breast cancer about 50 women, and the number is growing. At the same time the number of women who die from breast cancer is falling, because the treatment is improved, and the disease is detected at an earlier stage. However, after treatment, there is a risk of recurrence. About 4% of women are faced with a tumor in the same breast, and 5% of new tumor appears in the other. The purpose of the subsequent visits to the doctor - to identify relapse as early as possible.
Although breast cancer treatment becomes more personalized, it is not yet completely adapted to the real risk that the patient is exposed. "Currently, monitoring of breast cancer is the same for all in the first five years: mammography and physical examination every year. After five years, according to the current rules, follow-up depends on the age of the patient. Patients have a different risk of relapse, so it would be more logical if the women who are at low risk, visited the doctor less often, and women at high risk were followed up after five years. About half of all recurrences are detected by the patients themselves, but not during subsequent visits. And while subsequent results can give encouraging results, mammography and follow-up visits can cause anxiety and uncertainty. Therefore, if some women there is a very low risk of recurrence, in fact, it is an unnecessary burden, "- says Witteveen.
Therefore, it is important that follow-up has been optimized on the basis of individual risk. To determine the risk, it was created Dutch cancer registry, which records almost all new cases of cancer in 1989. Together with the Netherlands Organization Oncology and health care providers, Witteveen developed a nomogram to determine the risk of recurrence. Witteveen The study also found that the monitoring of breast cancer can be optimized for every possible risk profile, taking into account the benefits of early detection. This model allows physicians and patients together to assess the risks and make the most appropriate decisions. Women who are at higher risk can be assigned to more frequent inspections.