Improving the quality and cost-effectiveness of breast cancer follow-up

In the Netherlands, annually almost 13.000 women get breast cancer. After completion of the treatments, the patient remains under observation for a long time, also called the follow-up. The guideline in the Netherlands is a three-monthly hospital check in the first year after the treatment, but there are doubts whether these frequent checks provide optimum care. Studies among 320 breast cancer patients from seven hospitals in the Netherlands show that a number of hospital checks in the first year can be replaced by telephone checks by the mammacare nurse, maintaining quality of life, high patient satisfaction and no increase of anxiety feelings. Moreover, the combination of telephone follow-up and an educational group programme appears to be a cost-effective strategy. Based on these results, it is advised to critically examine the guideline for follow-up for the first year after breast cancer and to implement telephone follow-up and the educational group programme in the guideline.