Popularity of less frequent follow up for breast cancer in randomised study: initial findings from the hotline study.
OBJECTIVE
To compare the experiences of patients with breast cancer who were conventionally monitored with those in whom routine follow up was restricted to the time of mammography.


METHODS
Randomisation to conventional schedule of clinic visits or to visits only after mammography. Both cohorts received identical mammography and were invited to telephone for immediate appointments if they detected symptoms.


METHODS
Combined breast clinic, Chelsea and Westminster Hospital.


METHODS
211 eligible outpatients with a history of breast cancer.


METHODS
Acceptability of randomisation, interim use of telephone and general practitioner, satisfaction with allocation to follow up.


RESULTS
Of 211 eligible patients, 196 (93%) opted for randomisation in the study. Of these, 55 were under 50 years, 78 were diagnosed fewer than five years before, 90 had stage T2-4 tumours, and 71 had involved axillary nodes. Patients who did not participate were more likely to be under 50 years, to be two to five years after diagnosis, and to have had aggressive primary disease. Twice as many patients in both groups expressed a preference for reducing rather than increasing follow up. No increased use of local practitioner services or telephone triage was apparent in the cohort randomised to less frequent follow up by specialists.


CONCLUSIONS
Reducing the frequency of routine follow up has so far proved popular among patients with breast cancer at standard risk in this cohort. A multicentre study is needed to determine the effectiveness and cost-effectiveness of routine follow up with respect to disease outcomes.
Gulliford
T
T
Department of Medical Oncology, Charing Cross Hospital, London.
Opomu
M
M
Wilson
E
E
Hanham
I
I
Epstein
R
R
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001071:Appointments and Schedules; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000523:psychology / Q000628:therapy*; D015331:Cohort Studies; D017281:Cost of Illness; D018450:Disease Progression; D005500:Follow-Up Studies; D015277:Hotlines; D006801:Humans; D008131:London; D008327:Mammography; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D018579:Patient Selection; D013997:Time Factors