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• All visits should include a medical history. For women who are taking tamoxifen, it is important to ask about vaginal bleeding. Physical examination should include breasts, regional lymph nodes, chest wall, lungs and abdomen. The arms should be examined for lymphedema. Annual visits should include mammographic examination.

• Routine laboratory and radiographic investigations should not be carried out for the purpose of detecting distant metastases.• Patients should be encouraged to report new, persistent symptoms promptly, without waiting for the next scheduled appointment.• If a woman wishes to carry out breast self-examination, it is reasonable to teach her the proper procedure.• Psychosocial support should be encouraged and facilitated.