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Breast cancer follow-up in the adjuvant setting

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Abstract

Breast cancer may recur through 15 years and beyond after diagnosis; thus, breast cancer patients require long-term follow-up after adjuvant treatment to detect recurrent disease. History taking, physical examination, and regular mammography are still the foundation of appropriate breast cancer follow-up in the adjuvant setting. Clearly, breast MRI has a role in certain high-risk patients, but in moderate-risk patients, the decision to use MRI must be based on the complexity of the clinical scenario. Other routine imaging studies (CT, positron emission tomography, and bone scans) and laboratory testing—including tumor marker assessments—in asymptomatic patients have not demonstrated an improvement in survival, quality of life, toxicity, or cost-effectiveness. Survivorship issues are also an inherent part of breast cancer follow-up; physicians should make every effort to address supportive care issues unique to breast cancer survivors including hot flashes, bone health, neuropathy, and risk-reduction strategies.

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References and Recommended Reading

  1. Jemal A, Siegel R, Ward E, et al.: Cancer statistics, 2006. CA Cancer J Clin 2006, 56:106–130.

    PubMed  Google Scholar 

  2. Giordano SH, Buzdar AU, Smith TL, et al.: Is breast cancer survival improving? Cancer 2004, 100:44–52.

    Article  PubMed  Google Scholar 

  3. Olivotto IA, Bajdik CD, Ravdin PM, et al.: Population-based validation of the prognostic model ADJUVANT! for early breast cancer. J Clin Oncol 2005, 23:2716–2725.

    Article  PubMed  Google Scholar 

  4. Paik S, Tang G, Shak S, et al.: Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol 2006, 24:3726–3734.

    Article  PubMed  CAS  Google Scholar 

  5. Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. American Society of Clinical Oncology. J Clin Oncol 1996, 14:671–679.

  6. Khatcheressian JL, Wolff AC, Smith TJ, et al.; American Society of Clinical Oncology: American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol 2006, 24:5091–5097.

    Article  PubMed  Google Scholar 

  7. Grunfeld E, Dhesy-Thind S, Levine M; Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer: Clinical practice guidelines for the care and treatment of breast cancer: follow-up after treatment for breast cancer (summary of the 2005 update). CMAJ 2005, 172:1319–1320.

    PubMed  Google Scholar 

  8. The NCCN Breast Cancer Clinical Practice Guidelines in Oncology (Version 2.2007). 2007 National Comprehensive Cancer Network, Inc.http://www.nccn.org/professionals/physician_gls/PDF/breast.pdf. Accessed July 16, 2007.

  9. Recommended breast cancer surveillance guidelines. American Society of Clinical Oncology. J Clin Oncol 1997, 15:2149–2156.

  10. Smith TJ, Davidson NE, Schapira DV, et al.: American Society of Clinical Oncology 1998 update of recommended breast cancer surveillance guidelines. J Clin Oncol 1999, 17:1080–1082.

    PubMed  CAS  Google Scholar 

  11. The GIVIO Investigators: Impact of follow-up testing on survival and health-related quality of life in breast cancer patients: a multicenter randomized controlled trial. JAMA 1994, 271:1587–1592.

    Article  Google Scholar 

  12. Rosselli Del Turco M, Palli D, Cariddi A, et al.: Intensive diagnostic follow-up after treatment of primary breast cancer: a randomized trial—National Research Council Project on Breast Cancer Follow-Up. JAMA 1994, 271:1593–1597.

    Article  PubMed  CAS  Google Scholar 

  13. Rojas MP, Telaro E, Russo A, et al.: Follow-up strategies for women treated for early breast cancer. Cochrane Database Syst Rev 2005, (1)CD001768.

  14. Palli D, Russo A, Saieva C, et al.: Intensive vs clinical follow-up after treatment of primary breast cancer: 10-year update of a randomized trial. National Research Council Project on Breast Cancer Follow-up. JAMA 1999, 281:1586.

    Article  PubMed  CAS  Google Scholar 

  15. Holli K, Saaristo R, Isola J, et al.: Effect of radiotherapy on the interpretation of routine follow-up mammography after conservative breast surgery: a randomized study.Br J Cancer 1998, 78:542–545.

    PubMed  CAS  Google Scholar 

  16. Thomas DB, Gao DL, Ray RM, et al.: Randomized trial of breast self-examination in Shanghai: final results. J Natl Cancer Inst 2002, 94:1445–1457.

    PubMed  Google Scholar 

  17. de Bock GH, Bonnema J, van der Hage J, et al: Effectiveness of routine visits and routine tests in detecting isolated locoregional recurrences after treatment for early-stage invasive breast cancer: A meta-analysis and systematic review. J Clin Oncol 2004, 22:4010–4018.

    Article  PubMed  Google Scholar 

  18. Mille D, Roy T, Carrere MO, et al.: Economic impact of harmonizing medical practices: compliance with clinical practice guidelines in the follow-up of breast cancer in a French Comprehensive Cancer Center. J Clin Oncol 2000, 18:1718–1724.

    PubMed  CAS  Google Scholar 

  19. Grunfeld E, Mant D, Yudkin P, et al.: Routine follow up of breast cancer in primary care: randomised trial. BMJ 1996, 313:665–669.

    PubMed  CAS  Google Scholar 

  20. Loprinzi CL, Hayes D, Smith T: Doc, shouldn’t we be getting some tests? J Clin Oncol 2000, 18:2345–2348.

    PubMed  CAS  Google Scholar 

  21. Keating NL, Landrum MB, Guadagnoli E, et al.: Surveillance testing among survivors of early-stage breast cancer. J Clin Oncol 2007, 25:1074–1081.

    Article  PubMed  Google Scholar 

  22. Grunfeld E, Levine MN, Julian JA, et al.: Randomized trial of long-term follow-up for early-stage breast cancer: a comparison of family physician versus specialist care. J Clin Oncol 2006, 24:848–855.

    Article  PubMed  Google Scholar 

  23. Montgomery DA, Krupa K, Cooke TG: Alternative methods of follow up in breast cancer: a systematic review of the literature. Br J Cancer 2007, 96:1625–1632.

    Article  PubMed  CAS  Google Scholar 

  24. Gulliford T, Opomu M, Wilson E, et al.: Popularity of less frequent follow up for breast cancer in randomised study: initial findings from the hotline study. BMJ 1997, 314:174–177.

    PubMed  CAS  Google Scholar 

  25. Bornhak S, Heidemann E, Herschlein HJ, et al.: Symptomoriented follow-up of early breast cancer is not inferior to conventional control. Results of a prospective multicenter study. Onkologie 2007, 30:443–449.

    Article  PubMed  CAS  Google Scholar 

  26. Kuhl CK, Schrading S, Leutner CC: Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer. J Clin Oncol 2005, 23:8469–8476.

    Article  PubMed  Google Scholar 

  27. Leach MO, Boggis CR, Dixon AK: Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS). Lancet 2005, 365:1769–1778.

    Article  PubMed  CAS  Google Scholar 

  28. Lehman CD, Gatsonis C, Kuhl CK, et al.: MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. N Engl J Med 2007, 356:1295–1303.

    Article  PubMed  CAS  Google Scholar 

  29. Saslow D, Boetes C, Burke W, et al.; American Cancer Society Breast Cancer Advisory Group: American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin 2007, 57:75–89.

    Article  PubMed  Google Scholar 

  30. Vranjesevic D, Filmont JE, Meta J, et al.: Whole-body (18)F-FDG PET and conventional imaging for predicting outcome in previously treated breast cancer patients. J Nucl Med 2002, 43:325–329.

    PubMed  Google Scholar 

  31. Kamel EM, Wyss MT, Fehr MK, et al.: [18F]-Fluorode-oxyglucose positron emission tomography in patients with suspected recurrence of breast cancer. J Cancer Res Clin Oncol 2003, 129:147–153.

    PubMed  Google Scholar 

  32. Isasi CR, Moadel RM, Blaufox MD: A meta-analysis of FDG-PET for the evaluation of breast cancer recurrence and metastases. Breast Cancer Res Treat 2005, 90:105–112.

    Article  PubMed  CAS  Google Scholar 

  33. Drotman MB, Machnicki SC, Schwartz LH, et al.: Breast cancer: assessing the use of routine pelvic CT in patient evaluation. AJR Am J Roentgenol 2001, 176:1433–1436.

    PubMed  CAS  Google Scholar 

  34. Hurria A, Leung D, Trainor K, et al.: Screening chest imaging studies are not effective in the follow-up of breast cancer patients. J Oncol Manag 2003, 12:13–15.

    PubMed  Google Scholar 

  35. Gion M, Mione R, Leon AE, et al.: CA27.29: a valuable marker for breast cancer management. A confirmatory multi-centric study on 603 cases. Eur J Cancer 2001, 37:355–363.

    Article  PubMed  CAS  Google Scholar 

  36. Chan DW, Beveridge RA, Muss H, et al.: Use of Truquant BR radioimmunoassay for early detection of breast cancer recurrence in patients with stage II and stage III disease. J Clin Oncol 1997, 15:2322–2328.

    PubMed  CAS  Google Scholar 

  37. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG): Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005, 365:1687–1717.

    Article  CAS  Google Scholar 

  38. Institute of Medicine and National Research Council, Committee on Cancer Survivorship-Improving Care and Quality of Life, National Cancer Policy Board: From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, DC: National Academies Press; 2005.

    Google Scholar 

  39. Haggstrom DA, Quale C, Smith-Bindman R: Differences in the quality of breast cancer care among vulnerable populations. Cancer 2005, 104:2347–2358.

    Article  PubMed  Google Scholar 

  40. Keating NL, Landrum MB, Guadagnoli E, et al.: Factors related to underuse of surveillance mammography among beast cancer survivors. J Clin Oncol 2006, 24:85–94.

    Article  PubMed  Google Scholar 

  41. Mallinger JB, Griggs JJ, Shields CG: Patient-centered care and breast cancer survivors’ satisfaction with information. Patient Educ Couns 2005, 57:342–349.

    Article  PubMed  Google Scholar 

  42. Salminen E, Vire J, Poussa T, Knifsund S: Unmet needs in information flow between breast cancer patients, their spouses, and physicians. Support Care Cancer 2004, 12:663–668.

    PubMed  CAS  Google Scholar 

  43. Hodgkinson K, Butow P, Hunt GE, et al.: Breast cancer survivors’ supportive care needs 2–10 years after diagnosis. Support Care Cancer 2007, 15:515–523.

    Article  PubMed  Google Scholar 

  44. Newell S, Sanson-Fisher RW, Girgis A, Bonaventura A: How well do medical oncologists’ perceptions reflect their patients’ reported physical and psychosocial problems? Data from a survey of five oncologists. Cancer 1998, 83:1640–1651.

    Article  PubMed  CAS  Google Scholar 

  45. Shimozuma K, Ohashi Y, Takeuchi A, et al.: Assessment and quantification of taxane-induced neurotoxicity in a phase III randomized trial of breast cancer (AC followed by PAC/DOC vs. PAC/DOC alone): N-SAS BC 02 [ASCO abstract 8523]. J Clin Oncol 2006, 24:(Suppl):abstract 8523.

    Google Scholar 

  46. Gupta P, Sturdee DW, Palin SL, et al.: Menopausal symptoms in women treated for breast cancer: the prevalence and severity of symptoms and their perceived effects on quality of life. Climacteric 2006, 9:49–58.

    Article  PubMed  CAS  Google Scholar 

  47. Tham YL, Sexton K, Weiss HL, et al.: The adherence to practice guidelines in the assessment of bone health in women with chemotherapy-induced menopause. J Support Oncol 2006, 4:295–298, 304.

    PubMed  Google Scholar 

  48. Kissane DW, Grabsch B, Love A, et al.: Psychiatric disorder in women with early stage and advanced breast cancer: a comparative analysis. Aust N Z J Psychiatry 2004, 38:320–326.

    Article  PubMed  Google Scholar 

  49. Passik SD, Dugan W, McDonald MV, et al.: Oncologists’ recognition of depression in their patients with cancer. J Clin Oncol 1998, 16:1594–1600.

    PubMed  CAS  Google Scholar 

  50. Detmar SB, Muller MJ, Wever LD, et al.: The patient-physician relationship. Patient-physician communication during outpatient palliative treatment visits: an observational study. JAMA 2001, 285:1351–1357.

    Article  PubMed  CAS  Google Scholar 

  51. Janz NK, Wren PA, Copeland LA, et al.: Patient-physician concordance: preferences, perceptions, and factors influencing the breast cancer surgical decision. J Clin Oncol 2004, 22:3091–3098.

    Article  PubMed  Google Scholar 

  52. Bruera E, Willey JS, Palmer JL, et al.: Treatment decisions for breast carcinoma: patient preferences and physician perceptions. Cancer 2002, 94:2076–2080.

    Article  PubMed  Google Scholar 

  53. Holmes MD, Chen WY, Feskanich D, et al.: Physical activity and survival after breast cancer diagnosis. JAMA 2005, 293:2479–2486.

    Article  PubMed  CAS  Google Scholar 

  54. Chlebowski RT, Blackburn GL, Thomson CA, et al.: Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women’s Intervention Nutrition Study. J Natl Cancer Inst 2006, 98:1767–1776.

    Article  PubMed  Google Scholar 

  55. Pierce JP, Stefanick ML, Flatt SW, et al.: Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol 2007, 25:2345–2351.

    Article  PubMed  Google Scholar 

  56. Hortobagyi GN; American Society of Clinical Oncology: A shortage of oncologists? The American Society of Clinical Oncology Workforce study. J Clin Oncol 2007, 25:1468–1469.

    Article  PubMed  Google Scholar 

  57. Doubeni CA, Field TS, Ulcickas Yood M, et al.: Patterns and predictors of mammography utilization among breast cancer survivors. Cancer 2006, 106:2482–2488.

    Article  PubMed  Google Scholar 

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Correspondence to James Khatcheressian.

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Khatcheressian, J., Swainey, C. Breast cancer follow-up in the adjuvant setting. Curr Oncol Rep 10, 38–46 (2008). https://doi.org/10.1007/s11912-008-0007-x

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