What follow-up protocols should I implement for patients who have undergone treatment for breast cancer?

Follow-up protocols for patients treated for breast cancer should include:

• Annual mammography for 5 years post-treatment for all patients, including those with ductal carcinoma in situ (DCIS). Women should continue annual mammography beyond 5 years until they enter the NHS Breast Screening Programme (NHSBSP) or equivalent regional screening programmes.
• Mammography of the ipsilateral soft tissues after mastectomy is not recommended.
• Routine use of ultrasound or MRI for post-treatment surveillance is not recommended for patients treated for invasive breast cancer or DCIS.
• All patients should have an agreed, written care plan documented by a named healthcare professional from the multidisciplinary team. This plan should include details of surveillance mammography, review dates for adjuvant therapy, signs and symptoms to monitor, and contact details for specialist care and support services.
• Women at high or moderate risk of breast cancer with a personal history of breast cancer may require tailored surveillance, including annual MRI surveillance for women aged 30 to 49 years at high risk (e.g., BRCA1/2 mutation carriers), and mammographic surveillance according to age and risk profile.
• Support should be offered for psychological counselling, risk management advice, and breast awareness education.
• Lifestyle advice should be provided, encouraging maintenance of a healthy weight, limiting alcohol intake to below 5 units per week, and regular physical activity to reduce recurrence risk.

These protocols ensure early detection of recurrence and support patient well-being after breast cancer treatment.

References: NICE CG164, NICE NG101