Extended follow-up of breast cancer patients in clinic wastes time for both patients and doctors: the case for
Bibliographic record
Abstract
Numerous organizations have provided guidelines for clinical follow-up of women after they have undergone breast cancer treatment.The American Society of Clinical Oncology (ASCO) recommends clinic visits every 3 to 6 months for the first 3 years, visits every 6 to 12 months for the next 2 years, and annual visits after 5 years, with no advice on discharging patients [1].The Canadian Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer are more pragmatic regarding the frequency of visits, and suggests that these should be tailored to individual patient needs, but their recommendations explicitly state that follow-up should be provided indefinitely [2].The National Institute for Health and Clinical Excellence (NICE) in the UK suggests that clinical follow-up should be limited to only 2 or 3 years [3].There is also varying advice regarding mammographic followup.Mammography is recognized as important in the Canadian guidelines, with mammograms recommended annually [2], although the Canadian guidelines do concede that there is little high level evidence to support this practice.Similar recommendations are made by ASCO [1].In contrast, NICE suggests that the yield of mammography is low and that local networks should decide on their own policy.The British Association of Surgical Oncology has reported that the ideal frequency of mammography has not yet been established and that mammography every 1 to 2 years should be undertaken for up to 10 years after diagnosis [4].There is clearly disagreement between the groups that have published guidelines, but common to all of the guidelines is an emphasis on providing intensive follow-up during the first 3 to 5 years after diagnosis and treatment, with either reduced frequency of visits or discharge to the general practitioner thereafter.The bases of these guidelines are the perceptions that recurrent disease is most common in the first 3 to 5 years after treatment and that clinical examination remains an important component of follow-up.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.047 | 0.145 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.005 | 0.006 |
| Scholarly communication | 0.007 | 0.019 |
| Open science | 0.004 | 0.008 |
| Research integrity | 0.012 | 0.026 |
| Insufficient payload (model declined to judge) | 0.014 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".