Adherence to guideline recommendations for follow-up in patients with DCIS at a large teaching hospital in the Netherlands

K. K. Rajan*, J. J. Nijveldt, S. Verheijen, S. Siesling, M. A. Beek, A. B. Francken

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: Ductal-carcinoma in situ (DCIS) is a pre-invasive form of breast cancer with good prognosis. Follow-up guidelines in the Netherlands are currently the same as for invasive breast cancer. Due to fear of invasive breast cancer or recurrence, it is hypothesized that follow-up for DCIS after treatment is more intense in practice resulting in potentially unnecessary high costs. This study investigates the follow-up in practice for patients with DCIS compared to the recommendations in order to inform clinicians and policy makers how to utilize these guidelines. Methods: Patients diagnosed with pure DCIS between 2004 and 2014 were followed up until 2018. Information on duration and frequency of follow-up visits, reasons and decision makers for shortening, and prolonging follow-up was collected. Prolonged follow-up was defined as deviation from the Dutch guideline: more than 5 years of follow-up and older than 60 years. Results: Of the 227 patients the mean number of visits per year was 1.4 and mean years of follow-up was 6.0. Thirty-three percent had prolonged follow-up and 26% shorter follow-up than recommended. A majority (78%) of decision for prolonged follow-up was being made by clinicians. Conclusion: Follow-up duration is in almost half of patients with DCIS according to guidelines and with most prolonged follow-up only up to a year longer than recommended. In most cases suspicious findings and the timing of the population screening program appeared to cause prolonged follow-up. If accepted by patients and clinicians, future DCIS specific guidelines should address these reasons and tailor to the individual risks.

Original languageEnglish
Pages (from-to)633-640
Number of pages8
JournalBreast cancer research and treatment
Volume207
Issue number3
Early online date14 Jun 2024
DOIs
Publication statusPublished - Oct 2024

Keywords

  • 2024 OA procedure
  • Breast cancer
  • DCIS
  • Ductal-carcinoma in situ
  • Follow-up
  • Screening

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