Optimization of follow-up scenarios following breast cancer

Research output: Contribution to journalMeeting AbstractAcademic

Abstract

Purpose: Breast cancer occurs in about 1 in 9 women in the Netherlands. Every year, 11,000 new cases are registered and about 3,500 women die of breast cancer. Prognosis after primary treatment is improving, leading to an increased number of follow-up visits and increasing workload to physicians. National guidelines currently assign all these patients the same follow-up program: twice a year for 5 years. The present study was undertaken to determine an individualized follow-up program that gives women the follow-up they need and reduces physician workload.

Method: Breast cancer patients were classified according to different risk groups for recurrence based on age, tumor size and lymph node status. We chose follow-up programs with different frequency and length. To determine the most appropriate follow-up program for each patient group we modeled the process of breast cancer in a state transition model, and used discrete event simulation to investigate the effectiveness of various follow-up programs. Follow-up programs are compared based on the number of visits and quality adjusted life expectancy. We simulated 150,000 patients per patient group and follow-up program.

Result: For patients older than 70 years and patients with favorable tumor characteristics follow-up could be minimized to 1 visit. Patients younger than 40 years and patients with unfavorable tumor characteristics can benefit from a more intensive follow-up of twice a year for 5 years. Overall a reduction of 70% of needed follow-up visits can be quickly achieved.

Conclusion: The present study illustrates the potential for individualized follow-up in breast cancer patients. Implementing individualized follow-up can lead to a reduction of number of follow-up visits needed.
Original languageEnglish
Article numberESP-174
Pages (from-to)E137-E137
Number of pages1
JournalMedical decision making
Volume32
Issue number2
DOIs
Publication statusPublished - 2011
Event33rd Annual Meeting of the Society for Medical Decision Making, SMDM 2011: From Evidence to Decision Making: Role of Behavioral Economics in Medicine - Chicago, United States
Duration: 22 Oct 201126 Oct 2011
Conference number: 33
http://smdm.org/meeting/33rd-annual-north-american-meeting

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Breast Neoplasms
Workload
Physicians
Neoplasms
Group Processes
Life Expectancy
Netherlands
Lymph Nodes
Quality of Life
Guidelines
Recurrence

Cite this

@article{a9700e7df271401cbb44fc8284f2c50f,
title = "Optimization of follow-up scenarios following breast cancer",
abstract = "Purpose: Breast cancer occurs in about 1 in 9 women in the Netherlands. Every year, 11,000 new cases are registered and about 3,500 women die of breast cancer. Prognosis after primary treatment is improving, leading to an increased number of follow-up visits and increasing workload to physicians. National guidelines currently assign all these patients the same follow-up program: twice a year for 5 years. The present study was undertaken to determine an individualized follow-up program that gives women the follow-up they need and reduces physician workload.Method: Breast cancer patients were classified according to different risk groups for recurrence based on age, tumor size and lymph node status. We chose follow-up programs with different frequency and length. To determine the most appropriate follow-up program for each patient group we modeled the process of breast cancer in a state transition model, and used discrete event simulation to investigate the effectiveness of various follow-up programs. Follow-up programs are compared based on the number of visits and quality adjusted life expectancy. We simulated 150,000 patients per patient group and follow-up program.Result: For patients older than 70 years and patients with favorable tumor characteristics follow-up could be minimized to 1 visit. Patients younger than 40 years and patients with unfavorable tumor characteristics can benefit from a more intensive follow-up of twice a year for 5 years. Overall a reduction of 70{\%} of needed follow-up visits can be quickly achieved.Conclusion: The present study illustrates the potential for individualized follow-up in breast cancer patients. Implementing individualized follow-up can lead to a reduction of number of follow-up visits needed.",
author = "IJzerman, {Maarten J.} and Sabine Siesling and Joost Klaase and Erwin Hans",
year = "2011",
doi = "10.1177/0272989X12439390",
language = "English",
volume = "32",
pages = "E137--E137",
journal = "Medical decision making",
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}

Optimization of follow-up scenarios following breast cancer. / IJzerman, Maarten J.; Siesling, Sabine; Klaase, Joost; Hans, Erwin.

In: Medical decision making, Vol. 32, No. 2, ESP-174, 2011, p. E137-E137.

Research output: Contribution to journalMeeting AbstractAcademic

TY - JOUR

T1 - Optimization of follow-up scenarios following breast cancer

AU - IJzerman, Maarten J.

AU - Siesling, Sabine

AU - Klaase, Joost

AU - Hans, Erwin

PY - 2011

Y1 - 2011

N2 - Purpose: Breast cancer occurs in about 1 in 9 women in the Netherlands. Every year, 11,000 new cases are registered and about 3,500 women die of breast cancer. Prognosis after primary treatment is improving, leading to an increased number of follow-up visits and increasing workload to physicians. National guidelines currently assign all these patients the same follow-up program: twice a year for 5 years. The present study was undertaken to determine an individualized follow-up program that gives women the follow-up they need and reduces physician workload.Method: Breast cancer patients were classified according to different risk groups for recurrence based on age, tumor size and lymph node status. We chose follow-up programs with different frequency and length. To determine the most appropriate follow-up program for each patient group we modeled the process of breast cancer in a state transition model, and used discrete event simulation to investigate the effectiveness of various follow-up programs. Follow-up programs are compared based on the number of visits and quality adjusted life expectancy. We simulated 150,000 patients per patient group and follow-up program.Result: For patients older than 70 years and patients with favorable tumor characteristics follow-up could be minimized to 1 visit. Patients younger than 40 years and patients with unfavorable tumor characteristics can benefit from a more intensive follow-up of twice a year for 5 years. Overall a reduction of 70% of needed follow-up visits can be quickly achieved.Conclusion: The present study illustrates the potential for individualized follow-up in breast cancer patients. Implementing individualized follow-up can lead to a reduction of number of follow-up visits needed.

AB - Purpose: Breast cancer occurs in about 1 in 9 women in the Netherlands. Every year, 11,000 new cases are registered and about 3,500 women die of breast cancer. Prognosis after primary treatment is improving, leading to an increased number of follow-up visits and increasing workload to physicians. National guidelines currently assign all these patients the same follow-up program: twice a year for 5 years. The present study was undertaken to determine an individualized follow-up program that gives women the follow-up they need and reduces physician workload.Method: Breast cancer patients were classified according to different risk groups for recurrence based on age, tumor size and lymph node status. We chose follow-up programs with different frequency and length. To determine the most appropriate follow-up program for each patient group we modeled the process of breast cancer in a state transition model, and used discrete event simulation to investigate the effectiveness of various follow-up programs. Follow-up programs are compared based on the number of visits and quality adjusted life expectancy. We simulated 150,000 patients per patient group and follow-up program.Result: For patients older than 70 years and patients with favorable tumor characteristics follow-up could be minimized to 1 visit. Patients younger than 40 years and patients with unfavorable tumor characteristics can benefit from a more intensive follow-up of twice a year for 5 years. Overall a reduction of 70% of needed follow-up visits can be quickly achieved.Conclusion: The present study illustrates the potential for individualized follow-up in breast cancer patients. Implementing individualized follow-up can lead to a reduction of number of follow-up visits needed.

U2 - 10.1177/0272989X12439390

DO - 10.1177/0272989X12439390

M3 - Meeting Abstract

VL - 32

SP - E137-E137

JO - Medical decision making

JF - Medical decision making

SN - 0272-989X

IS - 2

M1 - ESP-174

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