Women with breast cancer: preferences for surveillance

Abstract

BACKGROUND: On completion of treatment people with breast cancer are offered surveillance at a hospital clinic and/or in primary care. It is unclear whom patients prefer to consult about their problems following cancer treatment. METHOD: Patients being followed up by a hospital nurse were surveyed at their follow-up appointment and three months later. The survey included demographic information, symptom profile, and the Patient Enablement Index (PEI). A subsequent survey of the patients' GPs confirmed which patients had consulted their GP prior to the nurse appointment. Three months after their appointment patients completed the PEI and were surveyed about their preference of practitioner for problems following treatment. RESULTS: 101 patients responded to the first survey and 60 patients to the follow-up survey. In 68% of cases women reported that they did not consult their GP about breast cancer related symptoms prior to their appointment at the clinic, choosing instead to present to a Breast Care Nurse (BCN). In the survey patients preferred their GP if they needed a physical examination (p = 0.007) or referral to a specialist (p <0.001). Older patients were more likely to choose a BCN if they wanted a mammogram and a GP if they wanted a physical exam or emotional support. The PEI scores after follow-up with the BCNs were equivalent to those reported following GP consultations. CONCLUSION: Patients prefer their GP overall, but we observed that the majority of women did not consult their GP when they had scheduled appointments with a BCN at a hospital clinic.