ASCO Issues Breast Cancer Surveillance Guideline Update

Asco Guidelines
Nov 09, 2012 2:58 PM
ASCO has issued an update to its guideline on breast cancer follow-up and management after primary treatment, which was published in the Journal of Clinical Oncology. The society’s Breast Cancer Surveillance Guideline Panel reviewed the available evidence published since the guideline’s last update in 2006 and determined that no revisions to the existing ASCO recommendations were warranted. The guideline’s recommendations also mirror one of ASCO’s Top Five opportunities (recommendation 4) to improve value and quality in care. The guideline and accompanying tools and resources can be accessed at: In addition, a patient information guide is available on ASCO’s award-winning patient information website, Cancer.Net.



Cynthia Riemer, RN
Re: ASCO Issues Breast Cancer Surveillance Guideline Update
Mar 03, 2013 11:53 AM

Hello,  I am not a researcher.  I am a former cancer survivor now battling metastatic breast cancer to the liver and peritoneum.  I read your short article about how ASCO is not adjusting their recommendations for follow up.  I am a member of a large, well known HMO and I had my primary cancer, ER+ invasive ductal ca, in 1997.  I had the advised treatment of sentinel node biopsy/lumpectomy with radiation.  There was no ca cells found in the three nodes they removed and they got clear margins at the lumpectomy site.  I have had the recommended f/u care ever since.
That was 15 years ago.  I elected not to take Tamoxifen at the time because I was pre menopausal and the risks did not outweigh the benefits.
My problem with the current recommended f/u care is that it missed my cancer.  And probably for a long time.  My primary cancer, a slow growing cancer, which is the same cancer I have now would probably have been caught many years ago had my HMO not followed recommended guidelines.
I say this because every year my regular bloodwork, mammogram, and physical exam were all normal.  I am a relatively healthy person and my current doctor says that my body has tolerated the current cancer inspite of how extensive it is.  Had my doctors routinely done other tests like scans and tumor markers even though there was not an apparent problem, I believe that I would not be facing the prognosis that I am facing now.
And because I don't believe that I am the only person in this situation, I think you do need to reevaluate your guidelines.  I am going to check with my current oncologist when I see him again in a couple of weeks to find out if in fact my HMO does follow your guidelines or if they have some other protocol of their own.  At any rate, I think the accepted f/u guidelines should include all the tests necessary to "leave no stone unturned" for anyone facing primary breast cancer of the breast.  Thank you.


Kaitlin Einhaus
Re: ASCO Issues Breast Cancer Surveillance Guideline Update
Mar 07, 2013 2:54 PM

Thank you very much for your comment. Please know that ASCO guidelines are developed by experts in the field and include patient representation. The guidelines are developed to provide recommended approaches after careful consideration of the best available evidence, however because every patient is unique, practice guidelines are not intended to substitute for the independent professional judgment of the treating physician. We wish you all the best and encourage you to have a discussion with your treating oncologist.