An evidence based strategy for follow up after breast conserving treatment for breast cancer

✍ Scribed by Michael Kontos; Pratik Roy; Demetrios Rizos; Hisham Hamed

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 92 KB
• Volume: 104
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/jso.21747

✦ Synopsis

Abstract

Background and Objectives

Follow up for breast cancer patients aims at the timely detection of loco‐regional recurrences and contralateral breast cancers (LRR). This study investigates the annual risk of LRR after breast conserving treatment (BCT) and the potential value of mammographic surveillance and/or routine clinical examination.

Methods

Data on 650 women who underwent BCT were obtained and LRR was divided into parenchymal and non‐parenchymal. LRR‐free and cumulative LRR‐free rates were calculated. In patients where recurrence was diagnosed at a routine clinic visit and had negative mammography (“clinical detection only” group) were also separately examined.

Results

Median follow up was 115 months, range 9–196. Seventy‐three patients had parenchymal and 16 nodal recurrence. The median probability of LRR was 1.4% and of parenchymal LRR was 1.32% per year, remaining constant for up to 168 months. The 16 patients in the “clinical detection only” group relapsed mainly during the first 2 years (annual risk 0.77% and 0.80%, respectively).

Conclusions

This study shows that the risk of parenchymal LRR remains constant for at least 14 years and is significant enough to warrant routine long‐term follow up mammography. Routine clinical examination contributes significantly to the detection of LRR only for the first 2 years. J. Surg. Oncol. 2011; 104:223–227. © 2011 Wiley‐Liss, Inc.