Self Directed Aftercare is a Safe, Efficient and well tolerated way to follow up Breast Cancer Patients

Abstract Aims Self Directed Aftercare (SDA) was introduced in the Belfast Trust in August 2012. It offered breast cancer patients treated with curative intent an opportunity to self-manage their 5 year follow up, including their annual mammograms. We reviewed the enrolment and outcomes for the first cohort reaching 5 years (diagnosed 2013). Methods The prospective SDA database identified patients on the pathway. Additional outcome data was collated through NIECR. Patient feedback was obtained at several points along the pathway. Results 342 patients underwent surgery for newly diagnosed breast cancer in 2013. 37.7% (129 patients) were enrolled in SDA. Of these, 62.8% (81 patients), remained on the pathway throughout their follow up. 33 patients (25.6%) required no further review, having had yearly mammograms and were discharged after 5 years. The remaining patients received reviews via rapid access or recalled through screening. Feedback was largely positive. Conclusions In its first full year of SDA implementation, the Belfast Trust achieved its target by enrolling 37.7% of patients. 25.6% of patients did not require any additional appointment thereby reducing waiting lists for outpatient surgical review. Of those with a concern, 100% were able to enter back in to the system. 85% of patients entered into SDA attended remote surveillance mammography appropriately. Patients report high levels of satisfaction with the pathway.