Table 3

Summary of themes identified in breast cancer literature

AuthorshipPublication dateLocationMethodologyPopulation (size of sample)Findings/themes identified
Adewuyi-Dalton et al531998UKQualitative—face to face one on one interviewsPatients (n=109)GPs—overworked; lack specialist knowledge; specialist care less important over time as concern about recurrence lessens
Brennan et al512010AustraliaQuantitative—questionnaireSecondary care (n=217)GPs need more training to follow-up patients
Brennan et al542011AustraliaQualitative—telephone interviewsPatients (n=20)Advantages GP care: convenience, reduced travel involved, take pressure off specialists
Disadvantages of GP care: poor communication between specialist and GP, GPs lack of knowledge, established relationship with specialist during treatment
Dawes et al582015USAMixed methods—questionnaire and focus groupPrimary care
(Survey n=59
Focus group n=36+)		Favoured specialists to provide follow-up care
Lack of knowledge especially endocrine treatment
Donelly et al452007UKQuantitative—questionnaireSecondary care (n=256)Advantages of GP care: reduced clinic workload
Disadvantages: lack of training, loss of outcome data
Kantsiper et al552009USAQualitative—focus groupPatients (n=21)
Primary care (n=15)
Secondary care (n=160		Specialists are experts and GPs role is in referral not management. Feelings of abandonment on discharge
Fear of missing recurrence and medicolegal implications, not able to keep up to date with information, poor communication from specialists
Better at detecting recurrence and managing side effects than GPs, like following up survivors (positive experience), establish bond with patient
Kerrigan et al462014IrelandQuantitativePatients (n=87)
Primary care (n=53)		Supportive of GP care: able to explain breast cancer, able to perform examination, easy links to specialist if needed
Increased workload and costs, concern regarding medicolegal aspects of care
Kwast et al562013NetherlandsQualitative—face to face interviewsPatients (n=23)
Clinicians (n=18)		GP—role in psychosocial aspects of care; lacks specialist knowledge; too busy
GP care cheaper; lack specialist knowledge
Luker et al572000UKQualitative—face to face/telephone interviewsPatients (n=67)
Primary care (n=31)		GP—lacks knowledge; delay in diagnosis associated with decreased confidence in follow-up
Difficult to keep up to date with new information, prognostication challenging
Mao et al502009USAQuantitativePatients (n=300)Holistic care through GP; psychosocial aspects of management; variable breast cancer specific knowledge
Mayer et al472012CanadaQuantitativePatients (n=218)Specialist visit reduces anxiety and improves survival compared with primary care
Roorda et al492013NetherlandsQuantitative—questionnairesPrimary care (n=502)40% of GPs happy to provide exclusive care after 5 years; barriers—patient preference, lack of knowledge, workload improving GP care improving GP care—active discharge from specialist care, written information, education, easy access back to specialist care if required
Smith et al482015CanadaQuantitativePatients (n=1065)
Primary care (n=587)		Confident in GPs ability to screen for recurrence, less confident in GPs managing osteoporosis, hormonal treatment
Confident in screening for recurrence, lower confidence in lymphoedema, family counselling, psychosocial aspects
Van Hezewijk et al522011NetherlandsQuantitative—questionnaireSecondary care (n=130)GPs should play a minor role in follow-up. Reasons not specified

  • GP, general practitioner.