NICE guidelines on how to follow-up breast cancer patients need to be urgently revised, say experts in the British Medical Journal (BMJ).
Follow-up protocols for breast cancer still vary both between and within countries and are not always based on evidence-based.
NICE in England and Wales argue that the aims of breast cancer follow-up are to detect and treat local recurrence, to deal with treatment effects and provide psychological support.
The guidelines say that this can be achieved through two to three years of follow-up and routine long-term follow-up is ineffective and unwarranted.
Breast cancer specialists in Scotland, however, argue that the NICE guidelines do not meet their stated aims.
Scottish experts say three years is not sufficient follow-up time to detect and treat local breast cancer recurrence.
They recommend that clinical examination should be annual for two years and surveillance by mammography thereafter.
Ongoing psychological support should also be available, and in between visits for mammograms, patients should have direct access to a named breast care nurse, specialist nurse or doctor and access to prosthesis advice and fitting.
Scottish experts say that patients' needs vary so follow-up programmes should be flexible and tailored to lifelong needs.