INFLUENCE - INdividualized FolLow-Up for brEast caNCEr

Incidence of breast cancer is rising. Fortunately, because of better treatment modalities and earlier detection the survival is rising as well. This combination leads to a growing group of women who are in need of follow-up care after breast cancer. One of the aims of follow-up is early detection of locoregional recurrence (LRR) while it leads to a better prognosis.

A LRR has a high risk of distant metastasis and thus confers a poor prognosis. LRRs are defined as the reappearance of breast cancer on the same site as the primary tumour, in the chest wall or ipsilateral, infraclavicular, supraclavicular or parasternal lymph nodes after curative treatment. In the Netherlands, patients are followed clinically for at least five years after their treatment. Still, most of the recurrences are detected by the women themselves in between follow-up visits and some are detected after the five years of clinical follow-up. Even though the risk factors are known, follow-up is the same for all patients and not dependent on the personal risk of the individual breast cancer patient. Since 2012 the national guideline of the Netherlands recommends an individualized follow-up by shared decision making, but does not provide recommendations on how to effectuate it. To achieve this, good insight in time- dependent individual LRR risk is necessary.

Together with the Comprehensive Cancer Organisation the Netherlands (IKNL), researchers from the University of Twente aim to identify patients with a low or high risk of LRR who might benefit from a less or more intensive follow-up after breast cancer and to determine individualized follow-up schedules.