What follow-up protocols should be implemented for male breast cancer survivors in primary care?

Follow-up protocols for male breast cancer survivors in primary care should include an agreed, written care plan documented by a named healthcare professional from the multidisciplinary team, with a copy provided to the patient and their GP. This plan must detail designated healthcare contacts, dates for review of any adjuvant therapy, surveillance imaging schedules, signs and symptoms warranting urgent advice, and contact information for specialist referral and support services such as lymphoedema care. Annual mammography should be offered for 5 years post-treatment, but mammography of the ipsilateral soft tissues after mastectomy is not recommended. Routine use of ultrasound or MRI for post-treatment surveillance is not advised. Additionally, patients should be counselled on lifestyle modifications including maintaining a healthy weight, limiting alcohol intake to below 5 units per week, and engaging in regular physical activity to reduce recurrence risk. Bone health assessment with DEXA scanning is generally not indicated for those on tamoxifen alone but may be considered if aromatase inhibitors or ovarian suppression are used, though this is more relevant to female patients. Overall, follow-up in primary care should be coordinated with specialist teams and tailored to individual treatment and risk profiles.