title: American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline.
abstract: Answer questions and earn CME/CNE The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made.
authors.affiliation: Executive Associate Dean for Academic Affairs and Professor, Department of Obstetrics and Gynecology, Herbert Wertheim College of Medicine Florida International University, Miami, FL.
authors.forename: Carolyn D
authors.initials: CD
authors.lastname: Runowicz
authors.affiliation: Director, Cancer and Aging Research, Behavioral Research Center, American Cancer Society, Atlanta, GA.
authors.forename: Corinne R
authors.initials: CR
authors.lastname: Leach
authors.affiliation: Associate Professor, Division of Hematology/Oncology, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI.
authors.forename: N Lynn
authors.initials: NL
authors.lastname: Henry
authors.affiliation: Nurse Practitioner, Oncology/Hematology Sylvester Cancer Center at the University of Miami, Miami, FL.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Henry
authors.affiliation: Member/Volunteer, Oncology Nursing Society, Pittsburgh, PA.
authors.forename: Heather T
authors.initials: HT
authors.lastname: Mackey
authors.affiliation: Vice President, South Atlantic Division Health Systems, American Cancer Society, Atlanta, GA.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Cowens-Alvarado
authors.affiliation: Behavioral Scientist, Behavioral Research Center/National Cancer Survivorship Resource Center, American Cancer Society, Atlanta, GA.
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Cannady
authors.affiliation: Director, The George Washington University Cancer Institute, Washington, DC.
authors.forename: Mandi L
authors.initials: ML
authors.lastname: Pratt-Chapman
authors.affiliation: Director, Baptist Cancer Center, Memphis, TN.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Edge
authors.affiliation: Clinical Professor of Nursing, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Jacobs
authors.affiliation: Associate Professor and Director, Cancer and Aging Research Program, City of Hope, Duarte, CA.
authors.forename: Arti
authors.initials: A
authors.lastname: Hurria
authors.affiliation: Sidney K. Simon Distinguished Professor of Oncology Research and Chairman, Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC.
authors.forename: Lawrence B
authors.initials: LB
authors.lastname: Marks
authors.affiliation: Retired Head and Neck Surgeon, Survivorship Workgroup Member and Volunteer, American Cancer Society, Atlanta, GA.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: LaMonte
authors.affiliation: Professor of Medicine, University of Toronto, Division of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON.
authors.forename: Ellen
authors.initials: E
authors.lastname: Warner
authors.affiliation: Co-Director Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Gary H
authors.initials: GH
authors.lastname: Lyman
authors.affiliation: Distinguished Professor of Medicine and Health Policy & Management, Schools of Medicine and Public Health, University of California, Los Angeles, CA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
mesh_terms: D000328:Adult; D000368:Aged; D000570:American Cancer Society; D001828:Body Image; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology / Q000628:therapy*; D055088:Early Detection of Cancer; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D008487:Medical History Taking; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D016609:Neoplasms, Second Primary / Q000175:diagnosis; D010808:Physical Examination; D011788:Quality of Life; D018570:Risk Assessment; D017741:Survivors / Q000523:psychology; D014481:United States; D055815:Young Adult
keywords: breast cancer; care coordination; clinical care; follow-up; guideline; late effects; long-term effects; primary care; quality of life; survivorship; survivorship care plan