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Evaluating the De-Escalation of Surveillance for Patients Who Have Undergone Curative Treatment for Breast Cancer (De-Escalation)

30 aprile 2026 aggiornato da: Royal College of Surgeons, Ireland

Evaluating the De-Escalation of Surveillance for Patients Who Have Undergone Curative Treatment for Primary Breast Cancer - A Prospective, Randomised Controlled Trial

Patients who were diagnosed with breast cancer and have finished their treatment will be given the opportunity to be part of this study. These patients will have been attending surveillance at the Breast Centre in Beaumont Hospital, Ireland for 2 years prior. These patients, who are doing well after breast cancer treatment, will be given the opportunity to enrol in this study, potentially being discharged from in person surveillance after 2 years, while still attending for their annual mammogram. Investigators intend to find out if a simpler follow-up plan could work just as safely, while also improving the patients quality of life.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Breast cancer is the most common cancer in women around the world. That means a lot of women are affected by it every year, and it's important that investigators always look for ways to improve their care, not just during treatment, but afterwards too. After treatment for early-stage breast cancer, patients usually come back to the hospital for regular check-ups for up to five years. These visits are based on old guidelines, and even though breast cancer treatment has improved a lot over the years, the follow-up schedule has stayed the same. This study is being done to see if investigators can safely reduce the number of hospital visits after treatment, while still keeping patients healthy and well looked after.

Right now, in Ireland, patients are asked to attend follow-up appointments at 6, 12, 18, 24, 36, 48 and 60 months (that's every 6 to 12 months for five years). These clinic visits often involve long waits and can cause stress or anxiety. At the same time, patients are also invited for a mammogram once a year. Recent research shows that most recurrences of breast cancer are found by patients themselves or during their annual mammograms, not necessarily at these clinic visits. That is why investigators are looking at whether the number of hospital appointments can safely be reduced , without affecting patient safety.

In this study, some patients will continue with the usual five-year clinic schedule. Others will only attend hospital clinics for the first two years (at 6, 12, 18 and 24 months), and after that, they will no longer need to come in for the extra follow-up visits - but they will still have their annual mammograms as normal.

Investigators will also ask all participants to complete a short questionnaire once a year. This will help investigators understand how the different follow-up plans affect quality of life, and how patients feel about their care. This research study is taking place to find out if fewer hospital check-ups, combined with continued mammogram screening, is just as safe and possibly better for patients' wellbeing.

Tipo di studio

Osservativo

Iscrizione (Stimato)

560

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

  • Nome: Emma Forde, Medical Doctor & Scientist
  • Numero di telefono: +353896126509
  • Email: eforde@rcsi.com

Luoghi di studio

  • Irlanda
      • Dublin, Irlanda, D09Y177
        • Reclutamento
        • Beaumont Hospital
        • Contatto:
          • Emma E Forde, Licensed doctor
          • Numero di telefono: +353 018092060
          • Email: eforde@rcsi.ie
        • Contatto:
          • Professor ADK Hill, Professor and Chairman of Surgery
          • Numero di telefono: +353 018092060
          • Email: ADKHILL@rcsi.ie
        • Investigatore principale:
          • Arnold DK Hill, Professor of Surgery

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto
  • Adulto più anziano

Accetta volontari sani

No

Metodo di campionamento

Campione di probabilità

Popolazione di studio

Female patients, 18 years or older with a previous diagnosis of primary breast cancer who have completed two years of surveillance following curative treatment

Descrizione

Inclusion Criteria:

  • Female participants aged 18 years or older
  • Prior diagnosis of primary breast cancer treated with curative intent
  • Currently under cancer surveillance and at the 24-month follow-up timepoint
  • No clinical or radiological evidence of disease recurrence or metastasis at the time of recruitment (e.g., no palpable mass, skin or nipple changes, or suspicious findings on imaging)
  • Able to read, write, and speak English sufficiently to complete the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire (paper-based or via telephone)
  • Resident in the Republic of Ireland with a fixed address and intention to continue follow-up within the Irish healthcare system

Exclusion Criteria:

  • Evidence of breast cancer recurrence or metastatic disease at the time of recruitment
  • Inability to provide informed consent
  • Inability to complete study questionnaires (e.g., due to language barriers or cognitive impairment)
  • Not resident in the Republic of Ireland or not intending to remain in follow-up within the Irish healthcare system

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

Coorti e interventi

Gruppo / Coorte
Intervento / Trattamento
Control
Patients will attend routine hospital-based in-person surveillance according to current practice post initial diagnosis (i.e.: patients will receive six monthly in-person specialist surveillance appointments for the first 24 months following curative resection and treatment of their primary breast cancer. Thereafter, these patients will attend annually until five years surveillance is reached and they will then be discharged from the service). Every patient will undergo an annual mammogram until the age of seventy years (or if aged 70 at the time of diagnosis, they will have an annual mammogram for five years in total). All participants in this group will complete the health-related quality of life questionnaire, EQ5D5L at the 24 (2 year), 36 (3 year), 48 (4 year) and 60 month (5 year) timepoint
Intervention
Patients will attend hospital-based in-person specialist surveillance clinics according to the current practice post initial diagnosis for the first two years following curative resection and treatment of their primary breast cancer and then discharged from the service (i.e.: patients will receive six monthly specialist follow-up appointments for the first 24 months). Mammographic surveillance will be as described for the control group. Every patient will undergo an annual mammogram until the age of seventy years (or if aged 70 at the time of diagnosis, they will have an annual mammogram for five years in total). As per standard practice all results from these annual mammogram studies will be copied to the patients' general practitioner. If any abnormalities are detected on mammogram the patient will be contacted. All participants will complete the health-related quality of life questionnaire, EQ5D5L at the 24 (2 year), 36 (3 year), 48 (4 year) and 50 month (5 year) timepoint
Altro: Deescalation of surveillance
Patients will attend hospital-based in-person specialist surveillance clinics according to the current practice post initial diagnosis for the first two years following curative resection and treatment of their primary breast cancer and then discharged from the service (i.e.: patients will receive six monthly specialist follow-up appointments for the first 24 months). Mammographic surveillance will be as described for the control group. Every patient will undergo an annual mammogram until the age of seventy years (or if aged 70 at the time of diagnosis, they will have an annual mammogram for five years in total). As per standard practice all results from these annual mammogram studies will be copied to the patients' general practitioner. If any abnormalities are detected on mammogram the patient will be contacted. All participants will complete the health-related quality of life questionnaire, EQ5D5L at the 24 (2 year), 36 (3 year), 48 (4 year) and 50 month (5 year) timepoint.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Health Related Quality of Life
Lasso di tempo: Participants will complete the questionnaire (paper-based or via telephone with the Advanced Nurse Practitioner) at 2, 3, 4, and 5 years.
Health related quality of life will be assessed using the EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L). The EQ-5D-5L includes five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each with five levels of severity. Responses are converted into a single index value, typically ranging from less than 0 (worse than death) to 1 (full health), where higher scores indicate better health-related quality of life. The instrument also includes a visual analogue scale (EQ VAS) ranging from 0 to 100, with higher scores indicating better perceived health.
Participants will complete the questionnaire (paper-based or via telephone with the Advanced Nurse Practitioner) at 2, 3, 4, and 5 years.

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Recurrence Rate and Time to Recurrence
Lasso di tempo: Assessed at 2, 3, 4, and 5 years post enrollment, time to recurrence analyzed up to 5 years.
Recurrence rate will be defined as the proportion of participants diagnosed with disease recurrence during follow-up. Time to recurrence will be defined as the time from study enrollment to the date of first confirmed recurrence.
Assessed at 2, 3, 4, and 5 years post enrollment, time to recurrence analyzed up to 5 years.
Change in Number of Patients Attending via Symptomatic Referral Pathway
Lasso di tempo: Annually at 1, 2, 3, 4, and 5 years.
The number of participants attending through the symptomatic referral pathway will be recorded and compared before and after implementation of the intervention.
Annually at 1, 2, 3, 4, and 5 years.
Economic Burden of Surveillance Pathway
Lasso di tempo: Costs will be assessed annually over 5 years and analyzed at 5 year follow-up.
A cost analysis will be conducted comparing the standard surveillance pathway with the de-escalated surveillance pathway, including healthcare utilization costs.
Costs will be assessed annually over 5 years and analyzed at 5 year follow-up.
Waiting Time for Newly Diagnosed Breast Cancer Patients
Lasso di tempo: Assessed annually at 1, 2, 3, 4, and 5 years.
Waiting time will be defined as the time from referral to first outpatient appointment for patients with newly diagnosed breast cancer. Annual changes in waiting times will be evaluated.
Assessed annually at 1, 2, 3, 4, and 5 years.

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Royal College of Surgeons, Ireland

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

  • General practice vs surgical-based follow-up for patients with colon cancer: randomised controlled trial. Wattchow D A., Weller DP, Esterman A. et al. British Journal of Cancer (2006) 94, 1116 - 1121
  • Patient satisfaction with nurse-led telephone fiollow-up after curative treatment for breast cancer. Kimman M. L. , Bloebaum M. MF, Dirksen C. D, et al. BMC Cancer 2010, 10:174
  • Brown L, Payne S, Royle G. Patient initiated follow up of breast cancer. Psychooncology. 2002 Jul-Aug;11(4):346-55. doi: 10.1002/pon.576.
  • Follow-up in breast cancer: does routine clinical examination improve outcome? A systemic review of the literature. Montgomery DA, Krupa K, Cooke TG. British Journal of Cancer (2007) 97, 1632 - 1641
  • Assessing Mode of Recurrence in Breast Cancer to Identify an Optimised Follow-Up Pathway: 10-Year Institutional Review. Horan J., Reid C., Boland M.R. et al. Ann Surg Oncol 30, 6117-6124 (2023) https://doi.org/10.1245/s10434-023-13885-7
  • Comparison of breast cancer patient satisfaction with follow-up in primary care versus specialist care: results from a randomized controlled trial. Grunfeld E., Fitzpatrick R., Mant D. et al. British Journal of General Practice, 1999, 49, 705-710
  • 4) A systemic review of the effectiveness of patient-initiated follow-up after cancer. Dretzke J., Chaudri T., Balaji R. et al. Cancer Medicine. 2023;12:19057-19071
  • AGO Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2022. Ditsch N., W.cke A., Untch M., et al. Breast Care 2022;17:403-420
  • American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. Runowicz C. D., Leach C. R., PhD, Henry N. L., et al. CA Cancer J Clin 2016;66:43-73.VC 2015 American Cancer Society
  • National Cancer Control Programme (NCCP), Draft HSE National Clinical Guideline, Post-treatment follow-up of patients with breast cancer

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

11 dicembre 2025

Completamento primario (Stimato)

31 dicembre 2027

Completamento dello studio (Stimato)

1 giugno 2028

Date di iscrizione allo studio

Primo inviato

5 dicembre 2025

Primo inviato che soddisfa i criteri di controllo qualità

30 aprile 2026

Primo Inserito (Effettivo)

7 maggio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

7 maggio 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

30 aprile 2026

Ultimo verificato

1 dicembre 2025

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • 25/52

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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