Table 2. Characteristics of included studies.

Study	Year	Patient group	Percentage randomisation	Age	Primary therapy	Study design	Main outcome measures	Follow-up schedule	Duration of study or median follow up
Grunfeld	1996	Two hundred and ninety-six primary operable patients attending routine follow up at all stages of follow up and free of metastatic disease	66.5%	Mean 59.1 GP and 62.4 hospital (s.d. 10.3 and 12)	53% mastectomy, 47% Breast Conservation (BCT)	Randomised controlled trial of follow up in general practice vs hospital.	Quality of life as measured by several validated questionnaires. Number of recurrences. Number of deaths. Time to diagnose recurrence from onset of symptoms. No data on survival	3 monthly clinical examination and history during the first year, 6 monthly for 4 years, then annual in one hospital, with 3 monthly first year, 4 monthly second year, 6 monthly for 5 years and then annual in the other. General practice group as per hospital of diagnosis. One to two yearly mammograms.	18 months
Gulliford	1997	One hundred and ninety-six primary operable patients attending routine follow up over a 24-month period at all stages of follow up and free of metastatic disease	93%	56 <49 years, 96 =50–65 years and 41 >65 years	68% BCT, 32% mastectomy	Comparison of frequent follow up vs annual follow up	Acceptability of randomisation and overall satisfaction. Interim use of telephone and general practioner. No data on survival or quality of life	3 monthly clinical examination and history during first year, 4 monthly second year, 6 monthly for 5 years and then annual. One to two yearly mammogram, depending on whether mastectomy or BCT in the control group, annual clinical examination, history and mammogram in the trial group	Median 16 months
Brown	2002	Sixty-one primary operable patients attending routine follow up at all stages of follow up and free of metastatic disease	50%	Mean 63 standard clinic, 68 in patient initiated	66% BCT, 34% mastectomy	Traditional clinic follow up vs patient-initiated follow up	Quality of life using validated questionnaires and satisfaction using unvalidated structured interview. NO data on survival	4–6 monthly clinical examination and history for first 5 years then annual in control group vs on request only in the study group. Annual mammograms in both	12 months
Koinberg	2004	Two hundred and sixty-four primary operable patients attending routine follow up at all stages of follow up and free from metastatic disease	Not given	58.8 (s.d. 10.1) in traditional group, 60 (s.d. 10.3) in the on demand group	84% BCT, 16% mastectomy	Traditional clinic follow up vs follow up on demand coordinated by a breast care nurse	Quality of life and satisfaction using validated questionnaires. Number of contacts with health professionals. Number of events and survival	3 monthly clinical examination and history for 2 years, 6 monthly for 3 years then annual for 5 years and annual mammogram in traditional follow-up group, with appointments on demand only and annual mammograms in the nurse-led follow up on demand group	5 years
Baildam	2004	Five hundred and twenty-five primary operable patients attending routine follow up at all stages of follow up and free of metastatic disease	78%	Not given	Not given	Comparison of standard follow up with those by hospital doctors or specially trained breast care nurses	Number of events Anxiety by validated questionnaire. Satisfaction using validated questionnaire. Economic comparison NO survival comparison	Not given, but identical for both arms	Not given
Kokko	2005	Four hundred and seventy-two primary operable patients attending routine follow up at all stages of follow up and free of metastatic disease	Not given	56.9 in frequent follow up group, 60 in infrequent group	54% mastectomy, 46% BCT	A comparison of 3 vs 6 monthly follow up (and of intense vs as required investigations)	Event detection and cost per event detected No data on survival	3 vs 6 monthly clinical examination and history.	Median 4.2 years
Grunfeld	2006	Nine hundred and sixty-eight women between 9 and 15 months after diagnosis of early-stage breast cancer, who had completed treatment and were disease free	55%	Mean 60.9 (in both groups)	73% BCT, 20% mastectomy and 7% biopsy only	A comparison of follow up by general practioner vs hospital follow up	Quality of life using validated questionnaires. Significant clinical events (metastases related). Number of local recurrences and deaths	3–6 monthly for 3 years, 6 monthly for 2 years then annual, with annual mammogram	Median 4.5 years from diagnosis (3.5 from randomisation)

Abbreviations: BCT=breast conservation; s.d.=standard deviation.