title: Out-of-hospital follow-up after low risk breast cancer within a care network: 14-year results.
abstract: The delegation of low-risk breast cancer patients' follow-up to non-hospital practitionners (NHP), including gynaecologists and general practitioners, has been assessed prospectively within a care network in the Paris region. Patients with early stage breast cancer were eligible. The follow-up protocol was built according to international guidelines. By 2012, 289 NHPs were following 2266 patients treated in 11 centres. Median follow-up time was 7.4 years. The mean intervals between two consecutive consultations were 9.5 [9.2-9.8] months for women supposed to be monitored every 6 months and 12.5 [12.2-12.8] for those requiring annual monitoring. The relapse rate was 3.2% [2.1-4.3] at 5 years and 7.8% [5.9-9.7] at 10 years. Seventy one percent of relapses were diagnosed on a scheduled assessment. Only 6% were lost-to-follow-up. Delegating follow-up after low risk breast cancer to NHPs in a care network is feasible, well accepted and provides an alternative to follow-up in specialized centres.
authors.affiliation: Réseau GynécoMed, 103, rue Legendre, 75017 Paris, France. Electronic address: gynecomed@gmail.com.
authors.forename: Sophie
authors.initials: S
authors.lastname: Houzard
authors.affiliation: AP-HP, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
authors.forename: Coraline
authors.initials: C
authors.lastname: Dubot
authors.affiliation: Réseau GynécoMed, 103, rue Legendre, 75017 Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Fridmann
authors.affiliation: Réseau GynécoMed, 103, rue Legendre, 75017 Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Dagousset
authors.affiliation: Institut Curie, Site Paris, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Rousset-Jablonski
authors.affiliation: Institut Curie, Site Saint-Cloud, 35, rue Dailly, 92110 Saint-Cloud, France.
authors.forename: Nasrine
authors.initials: N
authors.lastname: Callet
authors.affiliation: Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75908 Paris Cedex 15, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Nos
authors.affiliation: Groupe Hospitalier Diaconesses-Croix Saint-Simon, 18, rue du Sergent Bauchat, 75012 Paris, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Villet
authors.affiliation: AP-HP, Hôpital Lariboisière, 2, rue Ambroise Paré, 75010 Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Thoury
authors.affiliation: Institut Gustave Roussy, 39 rue Camille Desmoulins, 94800 Villejuif, France.
authors.forename: Suzette
authors.initials: S
authors.lastname: Delaloge
authors.affiliation: Groupe Hospitalier Bichat-Beaujon, 46 rue Henri Huchard, 75018 Paris, France.
authors.forename: Flora
authors.initials: F
authors.lastname: Breuil Crockett
authors.affiliation: Institut Curie, Site Paris, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Fourquet
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods*; D001943:Breast Neoplasms / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011320:Primary Health Care / Q000379:methods*; D011446:Prospective Studies
keywords: Breast cancer; Follow-up; Organizational innovation; Primary-care physicians; Professional delegation