Open door and listening ear are best support for patients

EDITOR,—The data presented by Eva Grunfeld and colleagues confirm clinical experience that most recurrences of breast cancer are diagnosed by the patients themselves, who present to their general practitioner between routine hospital visits.1 The question therefore raised is not whether routine follow up can equally well be done in general practice but whether it should be done at all.

The only justification for routine follow up is when—as, for instance, in bladder cancer—the early detection of asymptomatic recurrence offers the patient appreciable benefit. Before devolving the discredited “no sign of recurrence” clinic to general practice we must address the fundamental question of what it is we are trying to achieve. I suggest that if we want to help and support our patients with breast cancer then an open door and a listening ear are better than the traditional follow up ritual.