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• W68651497 abstract "This study investigates the follow-up of breast cancer and took place from September 2007 untilFebruary 2008. One of the main goals of follow-up is to improve the survival of patients. Follow-upinfluences survival by detecting local recurrences and second primary tumors in an early stage,thereby reducing the risk of metastases.Breast cancer occurs in about one in eight women in the Netherlands. Every year, 11000 new casesare registered and about 3500 women die of breast cancer. Prognosis after primary treatment forpatients with breast cancer is improving. This leads to an increased number of patients in follow-up,which leads to increased workload. All patients are currently assigned the same follow-up: five yearslong, with a frequency of two consults per year, as national guidelines prescribe. This study wants todetermine a more individualized follow-up in order to give women the follow-up they need andreduce workload in hospitals.We classify various patient groups, according to age, tumor size and lymph node status. We choosefollow-up scenarios based on their type of consult (surgeon face-to-face, nurse practitioner face-toface,nurse practitioner telephone), frequency (once, twice per year) and length (one, three, fiveyears), and determine the most appropriate follow-up scenario for each patient group.To investigate the cost-effectiveness scenarios, we model the process of breast cancer in a discreteeventstate-transition model and measure the cost-effectiveness of all scenarios for all patientgroups.Primary recommendations flowing from the research are the following:This study illustrates the possibility and potential for individualized follow-up in varioustypes of cancer.Implementing individualized follow-up can lead to savings of up to 89% of the number ofconsults needed.We have come to the insight that in general, patients younger than 50 require a moreintensive follow-up than patients older than 70. Older patients have a lower lifeexpectancy, and therefore there are less QALYs to be gained and the effectiveness offollow-up is lower. Specific results are:o Patients older than 70 and with favorable tumor characteristics) are served bestwith a minimal follow-up of one year.o Patients younger than 40 and patients with unfavorable tumor characteristics (>3lymph nodes, tumor size > 2.0 cm) can benefit from a more intensive follow-upof five or possibly ten years.o Patients with age older than 40 but younger than 70 sometimes benefit from amore intensive follow-up, e.g. when younger than 50 and tumor size >2,0 cm." @default.
• W68651497 created "2016-06-24" @default.
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• W68651497 date "2008-01-01" @default.
• W68651497 modified "2023-09-27" @default.
• W68651497 title "Individualized breast cancer follow-up : cost-effectiveness for various follow-up scenarios" @default.
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