Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 2;32(5):323.
doi: 10.1007/s00520-024-08530-2.

The effectiveness of personalised surveillance and aftercare in breast cancer follow-up: a systematic review

Marissa C van Maaren  1   2 , Jolanda C van Hoeve  3   4 , Joke C Korevaar  5   6 , Marjan van Hezewijk  7 , Ester J M Siemerink  8 , Anneke M Zeillemaker  9 , Anneleen Klaassen-Dekker  3   4 , Dominique J P van Uden  10 , José H Volders  11 , Constance H C Drossaert  12 , Sabine Siesling  3   4 ; NABOR project group
Collaborators, Affiliations

The effectiveness of personalised surveillance and aftercare in breast cancer follow-up: a systematic review

Marissa C van Maaren et al. Support Care Cancer. .

Abstract

Purpose: Breast cancer follow-up (surveillance and aftercare) varies from one-size-fits-all to more personalised approaches. A systematic review was performed to get insight in existing evidence on (cost-)effectiveness of personalised follow-up.

Methods: PubMed, Scopus and Cochrane were searched between 01-01-2010 and 10-10-2022 (review registered in PROSPERO:CRD42022375770). The inclusion population comprised nonmetastatic breast cancer patients ≥ 18 years, after completing curative treatment. All intervention-control studies studying personalised surveillance and/or aftercare designed for use during the entire follow-up period were included. All review processes including risk of bias assessment were performed by two reviewers. Characteristics of included studies were described.

Results: Overall, 3708 publications were identified, 64 full-text publications were read and 16 were included for data extraction. One study evaluated personalised surveillance. Various personalised aftercare interventions and outcomes were studied. Most common elements included in personalised aftercare plans were treatment summaries (75%), follow-up guidelines (56%), lists of available supportive care resources (38%) and PROs (25%). Control conditions mostly comprised usual care. Four out of seven (57%) studies reported improvements in quality of life following personalisation. Six studies (38%) found no personalisation effect, for multiple outcomes assessed (e.g. distress, satisfaction). One (6.3%) study was judged as low, four (25%) as high risk of bias and 11 (68.8%) as with concerns.

Conclusion: The included studies varied in interventions, measurement instruments and outcomes, making it impossible to draw conclusions on the effectiveness of personalised follow-up. There is a need for a definition of both personalised surveillance and aftercare, whereafter outcomes can be measured according to uniform standards.

Keywords: Aftercare; Breast cancer; Personalised follow-up; Surveillance.

PubMed Disclaimer

Conflict of interest statement

MvM, JK, MvH, ES, AZ, AK, CD and SS are involved in a large multicentre study evaluating (cost-)effectiveness of personalised surveillance and aftercare in the Netherlands (NABOR study, ZonMw project number 10330032010001).

Figures

Fig. 1
Fig. 1
Flow chart of inclusion of publications. *Including Medline and keywords of Embase. **Including studies focusing on short-term dietary, cognitive behavioural, physical or psychoeducational interventions and interventions applied during active treatment
Fig. 2
Fig. 2
Overview of all outcome(s) (categories) in the 16 included studies. The solid lines indicate the number of studies that analysed a specific outcome category, and the patterned lines indicate the number of times the specific outcome is analysed. The latter numbers do not add up to the numbers in the solid lines, because in one study, multiple outcomes could have been analysed
Fig. 3
Fig. 3
Risk of bias assessment. Upper panel: RoB-2, risk of bias tool for randomised controlled trials; D1, randomisation process; D2, deviations from the intended interventions; D3, missing outcome data; D4, measurement of the outcome; D5, selection of the reported results. Lower panel: ROBINS-E, risk of bias tool for nonrandomised studies; D1, confounding; D2, measurement of the exposure; D3, selection of participants; D4, post-exposure interventions; D5, missing data; D6, measurement of the outcome; D7, selection of the reported results
See this image and copyright information in PMC

References

    1. Arnold M, Morgan E, Rumgay H, Mafra A, Singh D, Laversanne M, et al. Current and future burden of breast cancer: global statistics for 2020 and 2040. Breast. 2022;66:15–23. doi: 10.1016/j.breast.2022.08.010. - DOI - PMC - PubMed
    1. van der Meer DJ, Kramer I, van Maaren MC, van Diest PJ, S CL, Maduro JH, , et al. Comprehensive trends in incidence, treatment, survival and mortality of first primary invasive breast cancer stratified by age, stage and receptor subtype in the Netherlands between 1989 and 2017. Int J Cancer. 2021;148(9):2289–303. doi: 10.1002/ijc.33417. - DOI - PMC - PubMed
    1. Giaquinto AN, Sung H, Miller KD, Kramer JL, Newman LA, Minihan A, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541. doi: 10.3322/caac.21754. - DOI - PubMed
    1. Loibl S, Andre F, Bachelot T, Barrios CH, Bergh J, Burstein HJ, et al. Early breast cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2024;35(2):159–182. doi: 10.1016/j.annonc.2023.11.016. - DOI - PubMed
    1. West of Scotland Cancer Network. Breast Cancer Regional Follow-up Guideline v3.0. 2024. https://www.woscan.scot.nhs.uk/wp-content/uploads/Final-published_Breast.... Accessed on 15 Mar 2024

Publication types