Doc, S houldn't W e B e G etting S ome T ests?

ERE’S THE CASE: Mrs. Smith presents herself to a medical oncologist. She had been treated by oncology colleagues down the street (whose clinical abilities are respected). Having presented in the recent past with nodepositive, hormone receptor‐negative breast cancer, she subsequently completed all planned antitumor therapy, including breast-conserving surgery, adjuvant doxorubicin/ cyclophosphamide chemotherapy for four cycles, adjuvant paclitaxel chemotherapy for four cycles, and primary breast radiation therapy. She transferred her care to the present oncologist because she was concerned that her prior oncologist, although performing what she thought were detailed histories and physical examinations and recommending yearly mammograms, wasn’t recommending any other follow-up surveillance tests. She knew she still had an appreciable risk of cancer recurrence, and she knew other women from her support group who were getting regular follow-up tests, including chest x-rays and serum marker tests.

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