A new breast cancer survivorship care guideline created by the American Cancer Society (ACS) and the American Society of Clinical Oncology (ASCO) provides guidance to primary care and other clinicians caring for the estimated 3.1 million female adult survivors of breast cancer in the United States. The guidelines were published in CA: A Cancer Journal for Clinicians (doi:10.3322/caac.21319).
The guideline is the third in a continuing series to provide guidance on identifying and managing potential physical and psychosocial long-term and late effects of cancer and its treatment, as well as other key elements of adult posttreatment survivorship care. Previous guidelines address the needs of survivors of prostate and colorectal cancers.
The guideline recommends that breast cancer patients should undergo regular follow-up for breast cancer recurrence that includes evaluation with a detailed cancer-related history and physical examination, and screening for new primary breast cancers consistent with guidelines. However, data do not support evaluating for breast cancer recurrence with routine laboratory or imaging tests, except mammography when indicated, in asymptomatic patients.
Additional recommendations include counsel patients on the importance of maintaining a healthy lifestyle, monitor for posttreatment symptoms that can adversely affect quality of life, and encourage patients to adhere to endocrine therapy.
The guideline also includes information on a broad range of other issues, from cognitive impairment and body image to fatigue and care coordination.
“Breast cancer survivors face potentially significant impacts of cancer and its treatment and deserve high-quality, comprehensive, coordinated clinical follow-up care,” wrote the authors. “Primary care clinicians must consider each patient’s individual risk profile and preferences of care to address physical and psychosocial impacts.”