Skip to main content

Advertisement

SpringerLink
Log in

Reduced rates of cancer-related worries and mortality associated with guideline surveillance after breast cancer therapy

  • Report
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Objective. Guidelines have been developed for appropriate post-therapy surveillance for breast cancer recurrence. Two objectives of post-therapy surveillance are to support and counsel patients and to detect potentially curable local recurrences and new cancers in the opposite breast. The objective of this investigation was to assess the impact of guideline surveillance (history, physical examination, and annual mammography) on cancer-related worries and all-cause mortality.

Study design and setting. We collected data on a cohort of 303 Massachusetts women with stages I or II breast cancer diagnosed between 1992 and 1994. Cases were women with increasing cancer-related worries or decedents. We used risk-set sampling to match five controls to each case on follow-up time. Cases and members of their matched risk set were characterized with respect to receipt of guideline surveillance and covariates preceding the date of their outcomes.

Results. The adjusted odds ratio associating guideline surveillance in the preceding year with an increase in cancer-related worries equaled 0.37 (95% CI=0.14–0.99). The adjusted odds ratio associating continuous guideline surveillance with all-cause mortality equaled 0.66 (95% CI=0.51-0.86). Conclusion. The results are consistent with the stated objectives of surveillance follow-up of breast cancer patients after the completion of their primary therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Stat bite: Prevalence of cancer [news]. J Natl Cancer Inst 89: 1093, 1997. Also see http://www-dccps.ims.nci.nih.gov/SRAB/Prevalence/us99ct.pdf.

  • TJ Smith NE Davidson DV Schapira E Grunfeld HB Muss VG Vogel MR Somerfield (1999) ArticleTitleAmerican Society of Clinical Oncology 1998 update of recommended breast cancer surveillance guidelines J Clin Oncol 17 1080–1082 Occurrence Handle10071303 Occurrence Handle1:STN:280:DyaK1M7mvVylsw%3D%3D

    PubMed  CAS  Google Scholar 

  • The Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer: follow-up after treatment for breast cancer. Can Med Assoc J 158(S3): S65–S70, 1998

    Google Scholar 

  • H Kattlove RJ Winn (2003) ArticleTitleOngoing care of patients after primary treatment for their cancer CA Cancer J Clin 54 172–196 Occurrence Handle10.3322/canjclin.53.3.172

    Article  Google Scholar 

  • Report from the National Breast Cancer Consensus Conference: Management of newly diagnosed early breast cancer: a national approach to breast cancer control. Med J Aust 161(S7): S10–S16, 1994

    Google Scholar 

  • ML Wood CL McWilliam (1996) ArticleTitleCancer in remission: challenge in collaboration for family physicians and oncologists Can Fam Physician 42 899–910 Occurrence Handle8688693 Occurrence Handle1:STN:280:DyaK283lt1Kqsg%3D%3D

    PubMed  CAS  Google Scholar 

  • I Koinberg L Holmberg B Fridlund (2001) ArticleTitleSatisfaction with routine follow-up visits to the physician, the needs of patients with breast cancer Acta Oncol 40 454–459 Occurrence Handle10.1080/028418601750288163 Occurrence Handle1:STN:280:DC%2BD3MvlvVGntQ%3D%3D Occurrence Handle11504303

    Article  CAS  PubMed  Google Scholar 

  • S Morris AP Corder I Taylor (1992) ArticleTitleWhat are the benefits of routine breast cancer follow-up Postgrad Med J 1992 68 904–907 Occurrence Handle1:STN:280:DyaK3s7lslWrtQ%3D%3D

    CAS  Google Scholar 

  • M Grogan A Rangan V Gebski J Boyages (2002) ArticleTitleThe value of follow-up of patients with early breast cancer treated with conservative surgery and radiation therapy The Breast 11 163–169 Occurrence Handle14965664 Occurrence Handle1:STN:280:DC%2BD2c%2Fns1GntA%3D%3D

    PubMed  CAS  Google Scholar 

  • Consensus Conference on “Follow-up of breast cancer patients.” Consensus statement of the jury. Ann Oncol 6: S69–S70, 1995

  • S Greenstein Orel RH Troupin EA Patterson BL Fowble (1992) ArticleTitleBreast cancer recurrence after lumpectomy and irradiation: role of mammography in detection Radiology 183 201–206

    Google Scholar 

  • S Ciatto L Cataliotti P Pacini V Distante S Bianchi R Simoncini G Cardona M Rontini F Falli C Elbetti (1993) ArticleTitleCancer reoccurrence in the conserved breast: diagnostic features in a consecutive series of 102 cases Int J Oncol 3 337–339

    Google Scholar 

  • GM Senofsky HJ Wanebo MC Wilhelm MC Wihem T Pope RE Fechner W Broaddus D Kaiser (1986) ArticleTitleHas monitoring of the contralateral breast improved the prognosis in patients treated for primary breast cancer Cancer 57 597–602 Occurrence Handle3942996 Occurrence Handle1:STN:280:DyaL287gsFKmtQ%3D%3D

    PubMed  CAS  Google Scholar 

  • ASCO Surveillance Expert Panel. Recommended Breast Cancer Surveillance Guidelines. J Clin Oncol 15: 2149–2156, 1997

    Google Scholar 

  • The Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer: Introduction. Can Med Assoc J 158(S3): S1–S2, 1998

    Google Scholar 

  • E Grunfeld H Noorani L McGahan L Paszat D Coyle C van Walraven J Joyce C Sawka (2002) ArticleTitleSurveillance mammography after treatment of primary breast cancer: a systematic review The Breast 11 228–235 Occurrence Handle14965672 Occurrence Handle1:STN:280:DC%2BD2c%2Fns1GrtA%3D%3D

    PubMed  CAS  Google Scholar 

  • TL Lash RA Silliman (2001) ArticleTitleMedical surveillance after breast cancer diagnosis. Med Care 39 945–955 Occurrence Handle11502952 Occurrence Handle1:STN:280:DC%2BD3MvlslWhuw%3D%3D

    PubMed  CAS  Google Scholar 

  • RA Silliman SL Troyan E Guadagnoli SH Kaplan S Greenfield (1997) ArticleTitleThe impact of age, marital status, and physician-patient interactions on the care of older women with breast cancer Cancer 80 1326–1334 Occurrence Handle9317187 Occurrence Handle1:STN:280:DyaK2svmtFGjtA%3D%3D

    PubMed  CAS  Google Scholar 

  • ID Fleming JS Cooper DE Henson RVP Hutter BJ Kennedy GP Murphy et al. (1997) AJCC Cancer Staging Manual, 5th edn. Philadelphia: Lippincott Williams & Wilkins

    Google Scholar 

  • JE Ware (Eds) (1993) SF-36 Health Survey, Manual and Interpretation Guide. Boston, Massachusetts: The Health Institute Boston

    Google Scholar 

  • RA Silliman KA Dukes LM Sullivan SH Kaplan (1998) ArticleTitleBreast cancer care in older women: sources of information, social support, and emotional health outcomes Cancer 83 706–711 Occurrence Handle9708934 Occurrence Handle1:STN:280:DyaK1cznt1Kltw%3D%3D

    PubMed  CAS  Google Scholar 

  • CA Schag PA Ganz RL Heinrich (1991) ArticleTitleCancer Rehabilitation Evaluation System-short form (CARES-SF) A cancer specific rehabilitation and quality of life instrument. Cancer 68 1406–1413 Occurrence Handle1:STN:280:DyaK3MzjvFWhtQ%3D%3D

    CAS  Google Scholar 

  • MJ Brady DF Cella F Mo AE Bonomi DS Tulsky SR Lloyd S Deasy M Cobleigh G Shiomoto (1997) ArticleTitleReliability and validity of the functional assessment of cancer therapy-breast quality-of-life instrument J Clin Onc 15 974–986 Occurrence Handle1:STN:280:DyaK2s3htlyntQ%3D%3D

    CAS  Google Scholar 

  • CA McHorney JE Ware AE Raczek (1993) ArticleTitleThe MOS 36-item Short-Form Health Survey (SF-36): II Psychometric and clinical tests of validity in measuring physical and mental constructs. Med Care 31 247–263 Occurrence Handle1:STN:280:DyaK3s7ps1antA%3D%3D

    CAS  Google Scholar 

  • RA Silliman TL Lash (1999) ArticleTitleComparison of interview-based and medical record-based indices of comorbidity among breast cancer patients Med Care 37 339–349 Occurrence Handle10.1097/00005650-199904000-00004 Occurrence Handle1:STN:280:DyaK1M3ivVSjsQ%3D%3D Occurrence Handle10213015

    Article  CAS  PubMed  Google Scholar 

  • S Greenland (1987) ArticleTitleInterpretation and choice of effect measures in epidemiologic analyses Am J Epidemiol 125 761–768 Occurrence Handle3551588 Occurrence Handle1:STN:280:DyaL2s7otFKhtw%3D%3D

    PubMed  CAS  Google Scholar 

  • SAS Institute. The SAS System. Cary, North Carolina: SAS Institute; 1999.

  • S Greenland (1998) Chapter 21–Introduction to Regression Modeling K Rothman S Greenland (Eds) Modern Epidemiology, 2nd edn. Philadelphia Lippincott-Raven Pennsylvania 401–434

    Google Scholar 

  • GM Kiebert K Welvaart J Kievit (1993) ArticleTitlePsychological effects of routine follow up on cancer patients after surgery Eur J Surg 159 601–607 Occurrence Handle8130301 Occurrence Handle1:STN:280:DyaK2c7ns1GrtA%3D%3D

    PubMed  CAS  Google Scholar 

  • NS Weiss (2002) ArticleTitleCan the “specificity” of an association be rehabilitated as a basis for supporting a causal hypothesis Epidemiology 13 6–8 Occurrence Handle11805580

    PubMed  Google Scholar 

  • DV Schapira N Urban (1991) ArticleTitleA minimalist policy for breast cancer surveillance JAMA 265 380–382 Occurrence Handle1984538 Occurrence Handle1:STN:280:DyaK3M%2FotVaksg%3D%3D

    PubMed  CAS  Google Scholar 

  • MC Ormiston AG Timoney AR Qureshi (1985) ArticleTitleIs follow up of patients after surgery for breast cancer worthwhile J Royal Soc Med 78 920–921 Occurrence Handle1:STN:280:DyaL28%2Fmt1CmsA%3D%3D

    CAS  Google Scholar 

  • A Zwaveling GHR Albers W Felthuis J Hermans (1987) ArticleTitleAn evaluation of routine follow-up for detection of breast cancer recurrences J Surg Oncol 34 194–197 Occurrence Handle2434803 Occurrence Handle1:STN:280:DyaL2s7kt12hsg%3D%3D

    PubMed  CAS  Google Scholar 

  • JA Dewar GR Kerr (1985) ArticleTitleValue of routine follow up of women treated for early carinoma of the breast BMJ 291 1464–1467 Occurrence Handle3933711 Occurrence Handle1:STN:280:DyaL28%2Flt1Gisg%3D%3D Occurrence Handle10.1136/bmj.291.6507.1464

    Article  PubMed  CAS  Google Scholar 

  • JM Kurtz R Amalric H Brandone Y Ayme J Jacquemier JC Pietra D Hans JF Pollet C Bressac JM Spitalier (1989) ArticleTitleLocal recurrence after breast-conserving surgery and radiotherapy Cancer 63 1912–1917 Occurrence Handle2702564 Occurrence Handle1:STN:280:DyaL1M7psV2rtg%3D%3D

    PubMed  CAS  Google Scholar 

  • JB Dubois M Saumon-Reme J Gary-Bobo H Pourquier H Pujol (1990) ArticleTitleTumorectomy and radiation therapy in early breast cancer: a report of 392 patients Radiology 175 867–871 Occurrence Handle2343138 Occurrence Handle1:STN:280:DyaK3c3mtVahtw%3D%3D

    PubMed  CAS  Google Scholar 

  • R Calle JR Vilcoq B Zafrani P Vielh A Fourquet (1986) ArticleTitleLocal control and survival of breast cancer treated by limited surgery followed by irradiation Int J Rad Oncol 12 873–878 Occurrence Handle1:STN:280:DyaL283ltVagug%3D%3D Occurrence Handle10.1016/0360-3016(86)90379-2

    Article  CAS  Google Scholar 

  • GIVIO Investigators: Impact of follow-up testing on survival and health-related quality of life in breast cancer patients. JAMA 27: 1587–1592, 1992

    Google Scholar 

  • MR Del Turco D Palli A Cariddi S Ciatto P Pacini V Distante (1994) ArticleTitleIntensive diagnostic follow-up after treatment of primary breast cancer A randomized trial. JAMA 271 1593–1597

    Google Scholar 

  • VB Logager A Vestergaard J Herrstedt HS Thomsen K Zedeler P Dombernowsky (1990) ArticleTitleThe limited value of routine chest X-ray in the follow-up of stage II breast cancer Eur J Cancer 26 553–555 Occurrence Handle2144738 Occurrence Handle1:STN:280:DyaK3czotVCmuw%3D%3D

    PubMed  CAS  Google Scholar 

  • DS Boekhorst NG Peer RF van der Sluis T Wobbes TJ Ruers (2001) ArticleTitlePeriodic follow-up after breast cancer and the effect on survival Eur J Surg 167 490–496

    Google Scholar 

  • S Ciatto P Pacini C Andreoli A Iossa G Grazzini F Buranelli T Campa A Costa A Magni (1989) ArticleTitleChest X-ray survey in the follow-up of breast cancer patients Br J Cancer 60 102–103 Occurrence Handle2803907 Occurrence Handle1:STN:280:DyaK3c%2Fisl2rug%3D%3D

    PubMed  CAS  Google Scholar 

  • T Broyn J Froyen (1982) ArticleTitleEvaluation of routine follow-up after surgery for breast carcinoma Acta Chir Scand 148 401–404 Occurrence Handle7180336 Occurrence Handle1:STN:280:DyaL3s%2Fps1Wrug%3D%3D

    PubMed  CAS  Google Scholar 

  • C Andreoli F Buranelli T Campa A Costa A Magni M Pizzichetta S Ciatto (1987) ArticleTitleChest X-ray survey in breast cancer follow-up–a contrary view Tumori 73 463–465 Occurrence Handle3686679 Occurrence Handle1:STN:280:DyaL1c%2FntFOruw%3D%3D

    PubMed  CAS  Google Scholar 

  • P Hietanen M Miettinen J Makinen (1986) ArticleTitleSurvival after first recurrence in breast cancer Eur J Cancer Clin Oncol 22 913–919 Occurrence Handle3770048 Occurrence Handle1:STN:280:DyaL2s%2FjtVCrtg%3D%3D

    PubMed  CAS  Google Scholar 

  • A Worster ML Wood IR McWhinney MJ Bass (1995) ArticleTitleWho provides follow-up care for patients with early breast cancer Can Family Physician 41 1314–1320 Occurrence Handle1:STN:280:DyaK28%2Fis1Ojsg%3D%3D

    CAS  Google Scholar 

  • E Grunfeld R Fitzpatrick D Mant P Yudkin R Adewuyi-Dalton J Stewart D Cole M Vessey (1999) ArticleTitleComparison of breast cancer patient satisfaction with follow-up in primary care versus specialist care: results from a randomized controlled trial Br J Gen Practice 49 705–710 Occurrence Handle1:STN:280:DC%2BD3c3itVSqug%3D%3D

    CAS  Google Scholar 

  • H Brenner DA Savitz (1990) The effects of sensitivity and specificity of case selection on validity, sample size, precision, and power in hospital-based case–control studies. 181–192 Am J Epidemiol 132

    Google Scholar 

  • C Earle HJ Burstein EP Winer JC Weeks (2003) ArticleTitleQuality of non-breast cancer health maintenance among elderly breast cancer survivors J Clin Oncol 21 1447–1451 Occurrence Handle12697865

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

    Timothy L. Lash & Kerri Clough-Gorr

  2. Geriatrics Section, Boston Medical Center, Boston, MA, USA

    Timothy L. Lash & Kerri Clough-Gorr

  3. Department of Medicine, Boston University School of Medicine, Boston, MA, USA

    Timothy L. Lash & Rebecca A. Silliman

  4. Boston University Medical Center, 88 E. Newton Street, B2100, 02118, Boston, MA, USA

    Timothy L. Lash

Authors
  1. Timothy L. Lash
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kerri Clough-Gorr
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rebecca A. Silliman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Timothy L. Lash.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lash, T.L., Clough-Gorr, K. & Silliman, R.A. Reduced rates of cancer-related worries and mortality associated with guideline surveillance after breast cancer therapy. Breast Cancer Res Treat 89, 61–67 (2005). https://doi.org/10.1007/s10549-004-1472-z

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-004-1472-z

Keywords

Search

Navigation