Breast Cancer Follow-Up and Surveillance After Primary Treatment: ASCO Guideline Update
In brief
ASCO recommends yearly mammograms and risk-based follow-up for all early-stage breast cancer survivors
Based on a single trial and expert consensus, the updated ASCO guideline advises routine history, physical exam and annual mammography for every patient after curative treatment, with either virtual or in-person visits. Patients with locally advanced disease or residual cancer after neoadjuvant therapy should receive more intensive surveillance, while blood tests and extra imaging are optional until stronger evidence emerges.
- Journal
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology (Q1)
- Published
- 16 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Zeina Nahleh, Catherine M Alfano, Mark R Somerfield, Janie M Lee, Tina J Hieken, Allison Magnuson, et al.
- PMID
- 42462191
- DOI
- 10.1200/JCO-26-01700
Why clinicians should know about it
- Picked for Biochemistry (medical) (top studies of the week, 19 July 2026).
Abstract
PURPOSE: To offer clinicians recommendations concerning breast cancer follow-up and surveillance after primary treatment. METHODS: ASCO convened an Expert Panel to develop recommendations based on a systematic review and a formal consensus process. RESULTS: One randomized controlled trial (RCT) was identified and formed the evidentiary basis for the surveillance mammography guideline recommendation. No RCTs were identified that evaluated different follow-up approaches by risk of relapse in patients treated for early-stage breast cancer. Given the dearth of evidence identified in the systematic review of the literature, formal modified Delphi consensus-based recommendations were generated. RECOMMENDATIONS: The guideline offers recommendations on the role of a risk-based approach to the frequency and intensity of follow-up among patients with breast cancer in the adjuvant setting. Regular history, physical examination, and mammography are recommended for breast cancer follow-up. Either virtual or in-person visits can be offered. Certain patients at high risk of cancer recurrence warrant closer surveillance, such as those patients with locally advanced disease or residual disease following neoadjuvant chemotherapy. Recommendations on the use of blood-based biomarkers and supplemental imaging are provided. Guideline recommendations will be updated once additional evidence-based tools become available to better individualize surveillance.Additional information is available at www.ascopubs.org/topics/asco-guidelines/breast-cancer.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.