Table 2.

Key themes representing different types of oncologists’ reasons for participation in breast cancer follow-up care

Reasons for Follow-up	Oncology Provider Type	Representative Quotes
Responsibility for Ongoing Therapy		If a patient is getting a medication from me, I would definitely follow the patient because I’m responsible for the medication, so if a patient is getting medicine from me, I always, always follow the patient at least once a year.
	Medical Oncology	Do I think that a radiation oncologist or a surgical oncologist could manage those meds? Sure. But do I think that currently they have the comfort level or desire to do it? No, I don’t think so. Again, I could be wrong, but I would say, the vast majority of times, those questions are deferred to me, and I think probably rightfully so.
Strong Patient Relationship	Medical Oncology	I think the medical oncologists probably in some cases become the major person managing the long-term follow-up and the reason that occurs is in part because women who receive chemotherapy develop a relationship based on repeated visits over a period of time… So, I think for the women who receive chemotherapy, there’s probably a little more of identification of the oncologist as their physician.
Specific Skillsets	Surgical Oncology	So, I feel strongly as a surgeon that my job is to perform a good breast examination, even if the patients have mastectomy, or lumpectomy, I think an operated breast needs to be followed for life by a surgeon.
	Radiation Oncology	I think the other reason for a radiation oncologist to be involved is because the morbidity associated with radiation therapy in particular is late-term. It may not even become evident for 15 or 20 years. Our feeling is, nobody can recognize that with the astuteness that we can.
	Medical Oncology	Taking a global picture- A systemic difference. That’s what I think I’m looking at differently. And I’m sure all the other physicians are doing that as well but I guess I’m trying to look at it from a different standpoint. What I’m more worried about is systemic recurrence of the disease. That’s I think the biggest risk.
Ensure Follow-up is Received and Minimize Redundancy	Radiation Oncology	One of my pet peeves has always been patients having too many doctors in their follow-up care. So, if a patient has a preference to have me participate in their care, then I will certainly do it that way. If they have no other physicians, I will see them. So, otherwise, if there are already medical oncologists and surgical oncologists in this area that I know of, and I know them and I know their quality, then after the acute check of their radiation reactions and they’ve healed up, I discharge them.
	Surgical Oncology	If it is a patient who is, who has a double mastectomy who’s not going to have oncologic follow-up, someone with DCIS whose treatment was entirely surgical, then I will typically follow those in the long run.