who follows you long term and how long?

Good to hear from you, BLinthedesert, I think I will eventually be transferred to nurse practitioners (whom, I'm sure are wonderful) for both the breast surgeon (already will happen this coming year) and the radiation oncologist.  But, then again, I'm treated at Memorial Sloan Kettering, and they can't really have long-term patients hanging around with such a demand for their services.  The place is also run very efficiently, so it's much more cost efficient for us to see the nurse practitioners. I am assured that if there are acute problems, the senior attendings will be involved again.  So, interesting that your long-term follow-up will be with the RO.  Mine is so wonderful, I wish I could do that, but I can say the same for the surgeon.  MRI's are truly a mixed blessing, so I agree with your ambivalence about it.

My last mammogram with my BS was this past April. He said I am now on a yearly schedule and will probably see his assistant. No worries with that but my ONC was surprised he has me on an annual schedule given I am 2 1/2 years out. Still have to see her every 6 months from what I understand for 3 years so my next visit with her should be my last 6 months and I will be then going for yearly appts. I think my go to person would be my ONC but I would be comfortable calling my BS too. Havent seen my RO since my last Rads - he also told me he was available if I needed him. I know they all probably say that but I really like my doctors and I wouldnt hesitate to call any of them. diane

I think this is an interesting question.  For IDC patients who had chemo it seems automatic that the MO is the primary long term doc.  

For DCIS it is unclear. I am taking tamoxifen and see the MO every 6 months.  I also see the RO once a year. I haven't seen the BS since a few months after surgery.  Although both cover all the concerns, the MO clearly thinks mostly about systemic issues while the RO thinks about local/regional.  The MO orders blood work and the RO orders imaging.  If I want to discuss a particular question the best person to ask breaks along those lines.  

When I finish tamoxifen I expect the MO visits to go down to no more than once a year but I hope to keep up with both.  The good news is that my risk is low but the bad news is that it continues on past 5 years. I don't think that milestone means much for me or should make much difference in the follow-up.

My situation is different both because I'm in Canada and because I was treated at a cancer-only hospital.  So like ballet12's situation at MSK, the surgeons and MOs at my hospital just don't have the time to continue to see patients well past the end of their treatment - at least not those who are not on any medication and who are so very low risk (I know that they do see patients with more advanced diagnoses for 5 years). My BS saw me every 6 months for 2 years.  I only saw my MO twice; he was willing to continue to see me, but since I wasn't on Tamoxifen or any other treatment, I didn't see the point in wasting his time.  So at two years I was turned over to my family doctor, but with 2 strict instructions:  First, I was told that I should continue to get all my screenings that their hospital, so that the radiologist reviewing my images would have the history of my diagnosis and so that my BS and the MO would be able to immediately access the images and reports should there ever be a need.  Second, I was told that I should be getting annual mammos and MRIs, alternating every 6 months, and that I should continue with that for as long as the radiologist felt it was necessary for me to have MRIs (7+ years later, she still does).  I passed that information along to my family doctor, and he agreed and since then has provided all the requisitions.

After my last MRI, I had a situation that required follow-up. I talked to my family doctor first, who contacted my oncologist's office and set up an appointment for me (in Canada you always need a referral for a specialist unless you are an on-going patient).  When I went for the appointment, I was pleased to find out that even though it was 6 years since I'd last seen him, the hospital and my oncologist's office treated me as an existing / current patient - no new forms to fill out or anything like that.  And all my records and reports and images were current and available for the MO to access.  Fortunately everything worked out fine and hopefully I don't have to see the MO again.

Anyway, all that to say that personally I think that the doctor who manages your long term follow-up doesn't really matter, so long as you get all the tests and checks you need, and so long as you have immediate access to your BS or MO, should there be a problem. As to who to yell to, I think that depends on the nature of the concern and who you feel is more appropriate to address it. 

What an interesting thread!

I'm only 6 months out and no one has told me much before the next time I need to see them, but for now it seems to be 6 months for the RO, BS, and MO (they are trying to stagger so I don't have all of them at once), and the BS said she would be "keeping an eye on" me for "a long time" - don't know what that means, but for the first 2 years, it's mammo's on the cancer side every 6 months, with the good side done yearly.

I am on Tamoxifen, so I assume I'll see the MO until I am done with that, but he refuses to commit to a particular length for that either - it's more like "take it until I see you again and we'll talk then".    The RO, I have no idea but I adore him, so am hoping that my next appointment with him in October isn't the last one - of the three, he's the one I'd most like to be followed up by, LOL.

Proudtospin - LOL at the Jersey plan!

I went with Dultz as the surgeon and the rest through the Princeton-Plainsboro system .... 

Awww .... thanks so much!!!