National randomised controlled trial is needed.

Dixon and Montgomery recommend that breast cancer follow-up be evidence based, flexible, and tailored to patients’ needs.1 Unfortunately neither their proposal to provide only annual clinical review for two years nor the 2002 guideline from the National Institute for Health and Clinical Excellence, which recommends hospital based follow-up for no longer than three years for asymptomatic patients, is evidence based. A recent Cochrane review showed a wide range of recommendations for follow-up practice and identified the urgent need for a large randomised controlled trial …