Breast Cancer Follow-Up and Management After Primary Treatment: American Society of Clinical Oncology Clinical Practice Guideline Update
Abstract
Purpose: To provide recommendations on the follow-up and management of patients with breast cancer who have completed primary therapy with curative intent. Methods: To update the 2006 guideline of the American Society of Clinical Oncology (ASCO), a systematic review of the literature published from March 2006 through March 2012 was completed using MEDLINE and the Cochrane Collaboration Library. An Update Committee reviewed the evidence to determine whether the recommendations were in need of updating. Results: There were 14 new publications that met inclusion criteria: nine systematic reviews (three included meta-analyses) and five randomized controlled trials. After its review and analysis of the evidence, the Update Committee concluded that no revisions to the existing ASCO recommendations were warranted. Recommendations: Regular history, physical examination, and mammography are recommended for breast cancer follow-up. Physical examinations should be performed every 3 to 6 months for the first 3 years, every 6 to 12 months for years 4 and 5, and annually thereafter. For women who have undergone breast-conserving surgery, a post-treatment mammogram should be obtained 1 year after the initial mammogram and at least 6 months after completion of radiation therapy. Thereafter, unless otherwise indicated, a yearly mammographic evaluation should be performed. The use of complete blood counts, chemistry panels, bone scans, chest radiographs, liver ultrasounds, pelvic ultrasounds, computed tomography scans, [ 18 F]fluorodeoxyglucose–positron emission tomography scans, magnetic resonance imaging, and/or tumor markers (carcinoembryonic antigen, CA 15-3, and CA 27.29) is not recommended for routine follow-up in an otherwise asymptomatic patient with no specific findings on clinical examination.
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Optimal comprehensive survivorship care delivery needs to go beyond screening of recurrences and new malignancies and include health promotion, identification and management of physical and psychosocial needs, and proper attention to concomitant chronic health conditions.
“It is now consensual that optimal comprehensive survivorship care delivery needs to go beyond screening of recurrences and new malignancies and include health promotion, identification and management of physical and psychosocial needs, and proper attention to concomitant chronic health conditions.8,10-12”
From Implementing a PROACTive Care Pathway to Empower and Support Survivors of Breast Cancer (2023) · cites this paper as [12]
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- Authors
- Khatcheressian, J. L., Hurley, P., Bantug, E., Esserman, L. J., Grunfeld, E., Halberg, F., Hantel, A., Henry, N. L., Muss, H. B., Smith, T. J., Vogel, V. G., Wolff, A. C., Somerfield, M. R., & Davidson, N. E.
- Affiliations
- American Society of Clinical Oncology (US)
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2013-03-01
- Volume
- 31
- Issue
- 7
- Pages
- 961-965
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2143037181
- Cited by
- 626
- References
- 19
- Citations by year
- 2026: 18 · 2025: 31 · 2024: 30 · 2023: 33 · 2022: 43 · 2021: 44 · 2020: 54 · 2019: 41 · 2018: 43 · 2017: 56 · 2016: 68 · 2015: 69 · 2014: 65 · 2013: 30 · 2012: 1
- FWCI
- 17.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pathology and Forensic Medicine › Breast Lesions and Carcinomas
- Keywords
- breast cancer, post-treatment follow-up, surveillance (medicine), breast-conserving surgery, mammography, physical examination, tumor markers, CA15-3, carcinoembryonic antigen, CA 27.29, curative intent
- MeSH terms
- Breast Neoplasms, Female, Humans, Mammography, Neoplasm Recurrence, Local, Palpation, Physical Examination, Population Surveillance, Time Factors, United States, Mastectomy, Segmental, Evidence-Based Medicine, Advisory Committees
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