Prevalence of long-term breast cancer survivors. Should primary care have a more relevant role on follow-up?

Abstract

Long-term breast cancer survivors (LTBCS) are cases in which more than five years have elapsed since diagnosis and there is no evidence of disease. In Spain, the follow-up of these women currently takes the form of medical visits attended at Oncology Departments, though scientific societies recommend that this follow-up be conducted by Primary Care. The aims of this study were to quantify: (a) the prevalence of LTBCS patients in Galicia (Spain); and (b) medical visits attended by LTBCS at Oncology Departments, i.e., visits that could be undertaken in Primary Care. Retrospective case series including all LTBCS in Galicia diagnosed from January 1, 2001 through December 31, 2017, and alive at June 30, 2022. We sourced the data from Galician Health Service Information Systems, and performed a descriptive analysis. A total of 15,121 LTBCS were identified. Mean and median age at diagnosis was 57 years. Of the women included, 14,063 did not present with a new breast tumor (93.0%), 991 (6.6%) presented with a new tumor, and 67 presented with two or more new tumors (0.4%). Prevalence of LTBCS was 1.0% overall, 1.2% among women aged 30 years and over without new tumors, and 1.4% among women aged 50 years and over. LTBCS generated a total of 78,717 medical visits at Oncology Departments; 94.1% had attended 20 or fewer medical visits five years or more after diagnosis. Prevalence of LTBCS in Galicia is high, as is the number of medical visits attended at Oncology Departments. These findings would justify specific follow-up protocols being drawn up and implemented by Primary Care.