Abstract
The post-treatment monitoring of breast cancer must incorporate not only the examination for local, regional or metastatic recurrence, but must also take into account the complications of therapy, psychological rehabilitation and re-adjustment to normal life. The follow-up should be shared by the various specialists who were involved in treating the patient, as well as the family doctor. This requires collaboration and the establishment of communication systems. As there have been no recent studies which might question the recommendations and guidelines which date back to 1995, there is no routine system to look for metastases using laboratory, radiological or isotopic investigations. These examinations are performed only if there are suggestive clinical features. The fact that these guidelines are based on very old studies should encourage the initiation of one or more prospective studies to update the recommendations, and, possibly, to develop them, if newprotocols and targeted therapy could demonstrate an advantage in patient survival.
Résumé
La surveillance post-thérapeutique des cancers du sein doit intégrer, outre la recherche d’une récidive locale, régionale ou métastatique, la prise en compte des complications thérapeutiques, la réhabilitation psychologique et les problèmes de réinsertion. Cette surveillance doit être partagée entre les différents spécialistes qui sont intervenus lors du traitement ainsi que le médecin référent, ce qui suppose une collaboration et la mise en place de réseaux. En l’absence d’études récentes qui remettraient en cause les recommandations et les référentiels qui datent de 1995, il n’y a pas lieu de prévoir à titre systématique des bilans biologiques ou des bilans radiologiques ou isotopiques à la recherche de métastases. Seuls des signes cliniques évocateurs justifient ces examens. Le fait que ces références soient basées sur des études très anciennes laisse la place à une ou plusieurs études prospectives pour réactualiser les recommandations et éventuellement les faire évoluer si l’apport des nouveaux protocoles ou des thérapies ciblées pouvait démontrer un bénéfice en termes de survie.
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Romieu, G. Surveillance post-thérapeutique des cancers du sein: état des lieux. Oncologie 12, 285–288 (2010). https://doi.org/10.1007/s10269-010-1879-6
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DOI: https://doi.org/10.1007/s10269-010-1879-6