Appropriate to offer patients with early breast cancer the opportunity for their follow-up care to be shared between a primary care physician and a specialist, to provide more accessible, whole-person care.
Context
Patients who have been treated for early breast cancer are at an increased risk of cancer recurrence or the development of a new primary breast cancer. Follow-up care is essential following completion of active treatment to check whether the breast cancer has recurred, to monitor side effects of treatment and to provide practical and emotional support.
Shared follow-up care is an innovative model of care that provides patients with early breast cancer the opportunity of having their follow-up care shared between their primary care physician and specialist. Several randomised controlled trials have shown that primary care-led follow-up is a safe and effective alternative to specialist follow-up with no differences in survival outcomes, breast cancer recurrences or serious clinical events.
Value to patients
Providing patients with the option for their follow-up care to be shared between their GP and a specialist has the potential to promote and support continuity of care and whole-person care, as the patient’s GP has oversight of all their health issues. Follow-up provided by a GP may improve access to care and be more convenient for the patient, reducing the need to travel to specialist services.
Supporting evidence
Emery JD, Shaw K, Williams B et al. The role of primary care in early detection and follow-up of cancer. Nature Reviews Clinical Oncology. 2014 Jan;11(1): 38-48.
Grunfeld E, Levine MN, Julian JA, et al. Randomized trial of long-term follow-up for early-stage breast cancer: A comparison of family physician versus specialist care. Journal of Clinical Oncology 2006;24: 848-55.
Lewis RA, Neal RD, Williams NH, et al. Follow-up of cancer in primary care versus secondary care: systematic review. British Journal of General Practice 2009;59: 234-7.
Ngune I, Jiwa M, McManus A, Hughes J. Do patients with long-term side effects of cancer treatment benefit from general practitioner support? A literature review. International Journal of Integrated Care. 2015;15: e023.
Taggart F, Donnelly P, Dunn J. Options for early breast cancer follow-up in primary and secondary care - a systematic review. BioMed Central Cancer. 2012;12: 238.