Effectiveness of routine and spontaneous follow-up visits for breast cancer.

The effectiveness of routine (initiated by the health services) and spontaneous (initiated by the patient) follow-up visits were compared based on a 5 year follow-up of all (551) breast cancer patients residing in one of the Finnish central hospital districts and diagnosed in 1977-1980. There were altogether 8248 visits, i.e. 4.6 per follow-up woman year, of which 2.7 visits were based on the recommended follow-up schedule. Recurrence (252) was detected in 14.7% of spontaneous visits which was five times more often than at the regular visit. False positive clinical diagnosis (63) was three times more frequent for spontaneous than for regular visits. The follow-up system should probably not be based solely on detecting of recurrences of the disease only but aspects related to the patient's quality of life may be decisive.