Breast cancer survivorship care: evidence based guideline recommendations for primary care physicians

Breast cancer is the most common cancer in women and effects over 1.5 million women each year. [1] As the number of survivors also increases [2] it’s essential that primary care physician (PCPs) have access to the best available evidence, and are able to provide optimal care for their patients, who may experience side effects such as depression, anxiety, fatigue and pain. [3]

However, a recent systematic review published in BMJ Open finds that the number of evidence based recommendations on breast cancer survivorship care for PCPs is limited.

Spronk et al performed a systematic database and website search with the help of national experts from 36 countries around the world. Breast cancer survivorship guidelines published in any language between 2012-2017 were included in the analysis.

In total, six guidelines were included and fifteen clinical topics were identified. Recurrence detection was the most popular clinical topic. Interestingly, none of the guidelines included recommendations on all topics. Out of the six guidelines included, two guidelines were identified as having an acceptable methodological quality. A lack of consistency between guidelines was demonstrated and many recommendations were found to be based on low quality evidence.

The study findings underline the need for more high-quality research that can be used to develop guidelines and support PCPs in providing optimal care for breast cancer survivors. Spronk et al conclude by highlighting the importance of involving PCPs in the development of such guidelines to help promote integrated care. As an area for future research, the authors emphasize the need to explore the views of both PCPs and patients on the usefulness of guidelines.