Breast Cancer Patients Receive Excellent Follow-up Care

Breast cancer patients are receiving excellent follow-up care from family doctors, a new study shows.

A Canadian research study, comparing follow-up care for breast cancer patients provided by family doctors with that provided by cancer specialists, has concluded that follow-up care by family doctors is a safe and acceptable alternative to specialist follow-up.

Details of the study were released today, Feb. 20, in the Journal of Clinical Oncology. The landmark study was funded by the Canadian Breast Cancer Research Alliance.

"This is great news for patients, cancer specialists and family physicians," said Dr. Eva Grunfeld, principal investigator and lead author of the study.

"The study confirms that Nova Scotia is, in many ways, leading the way, as the follow-up care for breast cancer patients here is already provided by family doctors," said Dr. Grunfeld, professor of medicine, Dalhousie University and Capital Health, and director, Cancer Outcomes Research Program, Cancer Care Nova Scotia.

She said the study results show that patients can be confident that the follow-up care they are receiving in their home community is comparable to the care they would be receiving if they travelled to a cancer centre.

"For cancer specialists, who have ever-increasing workloads and who are in high demand across Canada, the findings support a decision to focus their attention on patients who are in active treatment, with the knowledge that follow-up care is being ably handled by family physicians. At the same time, family physicians are to be commended for the high quality, follow-up cancer care they are providing in their communities," said Dr. Grunfeld.

The research study followed 968 Ontario women with early-stage breast cancer who had completed active treatment. Four hundred and eighty-three women received follow-up care from their family physician. They were referred back to the cancer centre if they had a recurrence or new primary cancer. The remaining 485 women received follow-up care from the cancer centre. Both groups were followed for a median of 3.5 years. Two outcomes were measured and compared: the number of serious clinical events and quality of life.

The results indicated that, 16 of those patients who received follow-up care from family physicians experienced a serious clinical event compared with 18 patients who received follow-up from the cancer centre.

Those who were followed by family physicians had 54 recurrences and 29 deaths, compared with 63 recurrences and 30 deaths for the group who were followed by the cancer centre. There were no differences between the groups in quality of life.

"We are committed to supporting the full spectrum of breast cancer research, including studies like this, which we expect will have an immediate impact on health services for women in communities across Canada," said Dr. Pascale Macgregor, research program director, Canadian Breast Cancer Research Alliance.

"These study results confirm the importance and quality of community cancer care," said Dr. Andrew Padmos, commissioner, Cancer Care Nova Scotia. "The issue of follow-up care and the need for quality cancer care at the community level will continue to grow as our population ages and as we continue to get better at diagnosing cancer earlier and treating it more effectively.

"Family physicians play an integral role in the strength and quality of our cancer system both today and into the future. By supporting them in their evolving role to provide community cancer care, we will enable our cancer specialists to focus on patients who require their expertise to determine best treatment options and care during the treatment," he said.

About 28,000 Nova Scotians are living with, living through or living beyond a cancer diagnosis. These numbers are expected to grow by 70 per cent over the next 10 years.

Dr. Grunfeld is a national leader in cancer health services research. In addition to her role at Capital Health and Dalhousie University, Dr. Grunfeld was the first recipient of Cancer Care Nova Scotia's Peggy Davison Cancer Research Scientist award. Before moving to Nova Scotia in January 2004, Dr. Grunfeld was at the Ottawa Regional Cancer Centre and the University of Ottawa.

Cancer Care Nova Scotia is a program of the Department of Health, created to reduce the burden of cancer on individuals, families, and the health-care system through prevention, screening, education and research.