Routine follow-up of patients after primary therapy for early breast cancer: changing concepts and challenges for the future.

In an era of increasing financial constraints, physicians are being forced to critically re-evaluate various clinical practices that have not been shown to be cost-effective or associated with definitive patient benefit. Routine follow-up programs following primary therapy for early-stage breast cancer vary widely from centre to centre, and although the subject of numerous retrospective analyses, they have not been prospectively evaluated to date. This review paper presents arguments for changing the emphasis of follow-up visits and stresses the need for prospective clinical and cost-benefit evaluations of current follow-up practices.