Tailoring fellow-up in early-stage breastcancer

Leiden Repository

Tailoring fellow-up in early-stage breastcancer

Type: Doctoral Thesis
Title: Tailoring fellow-up in early-stage breastcancer
Author: Hezewijk, Marjan van
Publisher: Department Radiotherapy, Faculty of Medicine / Leiden University Medical Center (LUMC), Leiden University
Issue Date: 2015-05-13
Keywords: Breast cancer
Follow-up
Locoregional recurrence
Professionals
Patiënts
Costs
Tailored care
Abstract: In this thesis the feasibility of tailored follow-up for early-stage breast cancer patients is evaluated. In order to do so, we first determined the risk of locoregional recurrence (LRR) dependent on local treatment in a large cohort of low-risk breast cancer patients, treated with adequate modern systemic therapy. In the second part we evaluated both patients’ and professionals’ needs and preferences for breast cancer follow-up and we reviewed the literature on cost effectiveness of known follow-up schedules. Finally we prospectively examined whether the implementation of a tailored follow-up programme, based on a prognostic index for LRR, is feasible and acceptable to patients and professionals. The results show that in general, implementation of minimised tailored follow-up seems feasible, but professionals tend to more frequent follow-up. Patients accept less intensive follow-up schedules and follow-up by a nurse practitioner. Given the low risk of LRR, tailoring should not only be done based on this risk, but individually, based on the presence of treatment related side effects, either physical or psychosocial. If patients do not experience side effects, annual planned mammography and telephone contact coordinated by a single professional, preferably a specialised nurse, suffice in case of easily accessible information and on demand visits.
Description: Promotores: C.A.M. Marijnen, C.J.H. van de Velde, Co-promotor: A.N. Scholten
With summary in Dutch
Faculty: LUMC
Citation: Hezewijk, M. van, 2015, Doctoral Thesis, Leiden University
ISBN: 9789462596139
Sponsor: The research in this thesis was financially supported the Dutch Cancer Society (project number UL 2008-4192) and Pfizer B.V. Financial support for the printing of this thesis was provided by the Bontius Stichting Doelfonds Klinische Oncologie, Pfizer B.V., Chipsoft B.V., Toshiba Medical Systems Nederland, and Elekta B.V.
Handle: http://hdl.handle.net/1887/32965
 

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application/pdf Chapter 1 Introduction 243.3Kb View/Open
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application/pdf Chapter 7 General discussion 163.7Kb View/Open
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application/pdf Publications_Curriculum Vitae_Acknowledgements 99.06Kb View/Open
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