%0 Journal Article
%T Adherence to guideline recommendations for follow-up in patients with DCIS at a large teaching hospital in the Netherlands.
%A Rajan KK
%A Nijveldt JJ
%A Verheijen S
%A Siesling S
%A Beek MA
%A Francken AB
%J Breast Cancer Res Treat
%V 0
%N 0
%D 2024 Jun 14
%M 38874687
%F 4.624
%R 10.1007/s10549-024-07391-x
%X <B>OBJECTIVE: </B>Ductal-carcinoma in situ (DCIS) is a pre-invasive form of breast cancer with good prognosis. Follow-up guidelines in the Netherlands are currently the same as for invasive breast cancer. Due to fear of invasive breast cancer or recurrence, it is hypothesized that follow-up for DCIS after treatment is more intense in practice resulting in potentially unnecessary high costs. This study investigates the follow-up in practice for patients with DCIS compared to the recommendations in order to inform clinicians and policy makers how to utilize these guidelines.<BR><B>METHODS: </B>Patients diagnosed with pure DCIS between 2004 and 2014 were followed up until 2018. Information on duration and frequency of follow-up visits, reasons and decision makers for shortening, and prolonging follow-up was collected. Prolonged follow-up was defined as deviation from the Dutch guideline: more than 5 years of follow-up and older than 60 years.<BR><B>RESULTS: </B>Of the 227 patients the mean number of visits per year was 1.4 and mean years of follow-up was 6.0. Thirty-three percent had prolonged follow-up and 26% shorter follow-up than recommended. A majority (78%) of decision for prolonged follow-up was being made by clinicians.<BR><B>CONCLUSIONS: </B>Follow-up duration is in almost half of patients with DCIS according to guidelines and with most prolonged follow-up only up to a year longer than recommended. In most cases suspicious findings and the timing of the population screening program appeared to cause prolonged follow-up. If accepted by patients and clinicians, future DCIS specific guidelines should address these reasons and tailor to the individual risks.