A retrospective study of earliest indicators of recurrence in patients on eastern cooperative oncology group adjuvant chemotherapy trials for breast cancer. A preliminary report
✍ Scribed by Kishan J. Pandya; Eleanor T. McFadden; Leslie A. Kalish; Douglass C. Tormey; Samuel G. Taylor IV; Geoffrey Falkson
- Publisher
- John Wiley and Sons
- Year
- 1985
- Tongue
- English
- Weight
- 363 KB
- Volume
- 55
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
A retrospective review of the Eastern Cooperative Oncology Group adjuvant chemotherapy studies EST 5177 and EST 6177 was performed in order to ascertain the first indicator of relapse in women with breast cancer and pathologically positive axillary lymph nodes. Of 856 evaluable patients, 208 have relapsed. In 175 patients who relapsed, the first indicator could be clearly identified: symptoms, 36%; patient self-examination, 18.3%; physical examination by the physician, 19.4%; abnormal blood chemistries, 12%; bone scans, 8%; chest x-rays, 5.1%; and mammograms, 1.1%. Although 74% of recurrences are therefore detected clinically, in a sizable proportion (26%), the ancillary tests were the earliest indicators of relapse. The manner of detection was not influenced by nodal, estrogen receptor (ER), or menopausal status. These results suggest that the follow-up schedule currently employed by ECOG appears reasonable.
Cuncer 55202-205. 1985.
HE CONCEPT that breast cancer with pathologically
T positive axillary lymph nodes is a systemic disease from the outset is now well-established. ' Adjuvant chemotherapy has been shown to improve disease-free s u r v i ~a l . ~-~ Despite this, a considerable number of patients relapse. For this reason, patients receiving adjuvant chemotherapy after mastectomy on clinical trials are followed carefully during and after completion of their treatment so as to detect recurrence as early as possible, primarily for calculation of a precise disease-free interval, but also for initiation of other systemic therapy as indicated. In addition to history and physical examina-