title: Postoperative follow-up practice of phyllodes tumour in the UK: Results from a national survey.
abstract: BACKGROUND
  Resected phyllodes tumours (PT) of the breast carry a small but significant risk of recurrence. Nevertheless, there are no national guidelines on the postoperative follow-up of these tumours potentially resulting in a wide variation in practice among breast surgeons in the UK.
  
  
  METHODS
  A web-based questionnaire was sent to breast surgeons across the UK to assess individual follow-up practices including availability of local guidelines, methods of follow-up and influence of risk factors.
  
  
  RESULTS
  Only 38% of 121 responses indicated the availability of local guidelines on PT follow-up. Modal follow-up duration for borderline and malignant disease was 5 years (53.7% and 79.3% of responses respectively), compared to 1 year for benign disease (43%) although 28% of respondents continue to review benign cases for 5 years. Immediate post-operative discharge and self-directed aftercare for benign and borderline cases remains uncommon practice in the UK. Within hospitals represented by more than one respondent in this survey, only around 30% demonstrated consistent practices pertaining to length and frequency of postoperative PT follow-up. Recurrent disease and margin status influenced the follow-up practice of 60% of respondents in our survey. More than 75% indicated that they combine clinical examination with radiological investigations (mammography and/or ultrasound) to follow up PT postoperatively.
  
  
  CONCLUSIONS
  This survey highlights the wide variation in follow-up practice for resected PT. This may affect the detection of disease relapse or, conversely, result in wasted clinical resources and unnecessary patient distress. Evidence-based national guidelines are necessary to resolve this issue and inform best follow-up practice.
authors.affiliation: The Breast Unit, Altnagelvin Area Hospital, Glenshane Road, Derry, Londonderry, BT47 6SB, UK.
authors.forename: Aimen
authors.initials: A
authors.lastname: Amer
authors.affiliation: Medical Biology Centre, Queens University Belfast, Lisburn Road, Belfast, BT9 7BL, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Ainley
authors.affiliation: The Breast Unit, Altnagelvin Area Hospital, Glenshane Road, Derry, Londonderry, BT47 6SB, UK.
authors.forename: Ronald
authors.initials: R
authors.lastname: Thompson
authors.affiliation: The Breast Unit, Altnagelvin Area Hospital, Glenshane Road, Derry, Londonderry, BT47 6SB, UK. Electronic address: Helen.mathers@southerntrust.hscni.net.
authors.forename: Helen
authors.initials: H
authors.lastname: Mathers
mesh_terms: D000359:Aftercare / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D003557:Phyllodes Tumor / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D011182:Postoperative Care / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D011184:Postoperative Period; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: Breast surgery; Follow up; Guidelines; Phyllodes tumour; Questionnaire