title: Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Virginia Cancer Institute, Richmond, VA, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Khatcheressian
authors.forename: Patricia
authors.initials: P
authors.lastname: Hurley
authors.forename: Elissa
authors.initials: E
authors.lastname: Bantug
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Esserman
authors.forename: Eva
authors.initials: E
authors.lastname: Grunfeld
authors.forename: Francine
authors.initials: F
authors.lastname: Halberg
authors.forename: Alexander
authors.initials: A
authors.lastname: Hantel
authors.forename: N Lynn
authors.initials: NL
authors.lastname: Henry
authors.forename: Hyman B
authors.initials: HB
authors.lastname: Muss
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Smith
authors.forename: Victor G
authors.initials: VG
authors.lastname: Vogel
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Wolff
authors.forename: Mark R
authors.initials: MR
authors.lastname: Somerfield
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Davidson
mesh_terms: D026683:Advisory Committees; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control* / Q000628:therapy; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008327:Mammography; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000517:prevention & control*; D010173:Palpation; D010808:Physical Examination; D011159:Population Surveillance / Q000379:methods; D013997:Time Factors; D014481:United States