Breast Cancer Follow-Up Care Guidelines

doctor and patient

Routine follow-up care is important for breast cancer survivors who have completed active treatment.  Six years after its last update, the American Society of Clinical Oncology (ASCO) has re-reviewed its recommendations on breast cancer follow-up care.  After considering 14 new publications, the committee concluded that no revisions to the previous guidelines are needed.  The following is a summary of ASCO’s recommendations for breast cancer follow-up care, as well as a summary of tests that are not recommended.

KEY RECOMMENDATIONS:

  • Regular medical history and physical exam

- every 3-6 months for 3 years after primary treatment

- every 6-12 months for years 4-5

- annually year 6 and beyond

  • Patient education about signs/symptoms of recurrence
  • Referral to genetic counseling when appropriate

- Ashkenazi Jewish Heritage

- patient history of ovarian cancer

- history of ovarian cancer in any first or second degree relative

- history of breast cancer before age 50 in any first degree relative

- two or more first or second degree relatives with a history of breast cancer

- patient or relative with a history of bi-lateral breast cancer

- family history of male breast cancer

  • Monthly breast self-exam
  • Mammography, for women treated with lumpectomy

- 1 year after the initial mammogram, but no sooner than 6 months after radiation therapy

- yearly thereafter (unless otherwise indicated)

  • Regular pelvic exam

 NOT RECOMMENDED:

The following tests are NOT RECOMMENDED for routine follow-up care of asymptomatic patients:

  • Routine blood tests (i.e. complete blood counts or automated chemistry studies)
  • Chest X-rays
  • Bone Scans
  • Liver Ultrasound
  • PET Scans
  • CT Scans
  • Breast MRIs
  • Tumor markers (i.e. CEA, CA 15-3, CA 27.29)

 

Source:  “Breast Cancer Follow-Up and Management After Primary Treatment:  American Society of Clinical Oncology Clinical Practice Guideline Update”