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The American Society of Clinical Oncology Recommended Breast Cancer Surveillance Guidelines Can Be Done in a Routine Office Visit

Virginia Commonwealth University, Division of Hematology/Oncology, MCV Box 980230, Richmond, VA

To the Editor:

The ASCO Recommended Breast Cancer Surveillance Guidelines¹ are being redone in 2005. Some oncologists have found these very useful in educating patients about what tests are helpful, and what tests are not helpful and not recommended.² One persistent objection to more widespread use of these guidelines has been the complaint that they may take too much time to review.

To see how much time the actual review took with patients, I did a consecutive timed review with 15 patients who were ending adjuvant treatment and ready to begin surveillance. I presented the printed patient follow-up guide (ASCO Patient Guide: Follow-Up Care for Breast Cancer) obtained from http://www.plwc.org to a sequential series of breast cancer patients, reviewed the guideline table with them, made spoken and written comments specifically for individual patients (Table 1), and timed the process. Approval for the study was granted by the Committee on the Conduct of Human Research; the study was exempt from consent requirements since it was a continuation of an already established office practice. The list of patient situations and actual times/discussion is available from the author.

Further research is needed to determine if this approach can be generalized to other practices and other practitioners, how best to present the information, and the comprehension of the knowledge, but at least the time issue should not be a burden.

Author's Disclosures of Potential Conflicts of Interest

The author indicated no potential conflicts of interest.

REFERENCES

1. Smith TJ, Davidson NE, Schapira DV, et al: American Society of Clinical Oncology 1998 update of recommended breast cancer surveillance guidelines. J Clin Oncol 17:1080-1082, 1999[Abstract/Free Full Text]

2. Loprinzi CL, Hayes D, Smith TJ: Doc, Shouldn't We Be Getting Some Tests? J Clin Oncol 18:2345-2348, 2000[Free Full Text]

3. Smith TJ, Desch CE, Hackney MH, et al: How long does it take to get a "do not resuscitate" order? J Palliat Care 13:5-8, 1997[Medline]

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