The numerous guidelines for following up women after treatment for breast cancer show little consistency. The lack of evidence to inform these guidelines means they are influenced by local economic concerns—prolonged and frequent follow-up is common for privately funded healthcare systems,1 whereas state funded health services limit the frequency and duration of visits.2 In the linked randomised controlled equivalence trial (doi:10.1136/bmj.a3147), Beaver and colleagues compare traditional hospital follow-up with telephone follow-up by specialist nurses in women treated for breast cancer.3

The National Institute for Health and Clinical Excellence recommends up to three years’ hospital follow-up before discharge to the general practitioner (although the guidelines are under review).2 4 Few clinicians follow these guidelines.5 Rather than unify practice the guidelines have led healthcare practitioners to look for cost effective methods of providing longer follow-up care. A range of strategies has been investigated, including radiographer led follow-up,6 automated telephone follow-up,7 and several variations on nurse led follow-up.8 9

Beaver and colleagues compare telephone follow-up by breast care nurses with follow-up …