New HSE National Clinical Guideline

NCCP publishes new national clinical guideline for post-treatment follow-up after breast cancer

The National Cancer Control Programme (NCCP) has developed a new HSE National Clinical Guideline, in line with the National Clinical Effectiveness Committee (NCEC) Standards for Clinical Practice Guidance.

The guideline aims to reduce variation in practice, improve patient outcome including their experience of care, and optimise service delivery.

The guideline is available on the HSE National Central Repository.

Overview

Following an extensive evidence review, the guideline was developed by a multidisciplinary team including clinicians, patient and service user partners, researchers and other key stakeholders. It provides evidence-based recommendations for clinical and radiological follow-up of patients with breast cancer. The recommendations represent a change from current practice.

Clinical follow-up

Evidence suggests that annual breast clinical appointments provide little value with regard to the detection of local recurrence as part of the optimum follow-up of breast cancer patients post-treatment.

The guideline now recommends

• One clinical appointment with the surgical team at one-year post-surgery.
• A patient should be referred urgently by their GP to the breast/oncology clinic if they develop signs or symptoms suspicious for local recurrence or metastasis.

Radiological follow-up

A recently published randomised controlled trial, conducted in the UK, demonstrated the safety of the newly recommended schedule.

The guideline now outlines the follow-up mammogram schedule for patients, based on age at diagnosis and tumour subtype.

 The guideline also highlights a number of good practice points for the care of patients following breast cancer treatment.

Who was involved?

The guideline was developed by a multi-disciplinary guideline development group. Full membership is available in the guideline. The group was co-chaired by:

• Prof Deirdre Duke, Consultant Radiologist, Beaumont Hospital,
• Prof Martin O’Sullivan, Consultant Surgeon, Cork University Hospital, and
• Dr Eve O’Toole, Head of Evidence & Quality Hub, NCCP.