Postoperative follow-up of patients with early breast cancer. Patterns of care among clinical oncologists and a review of the literature.
Eighty clinical oncologists in the southeastern United States were surveyed to determine their strategies for follow-up care after primary treatment of early-stage breast cancer. The frequency of use of the history and physical examination, complete blood count, liver function tests, carcinoembryonic antigen levels, chest x-ray, skeletal survey, bone scan, liver scan, and mammogram for observing hypothetical low- and high-risk patients was assessed. Yearly mammograms were recommended by more than 95% of respondents. History and physical examination were the modalities used most often, whereas periodic bone and liver scans were used only in a minority of patients. A review of the literature supported the strategy of the respondents in this survey and further underscored the cost-effectiveness of the history and physical examination in detecting recurrence during follow-up. Based on this survey and supporting literature, recommendations for reasonable yet cost-conscious follow-up are presented.
Loomer
L
L
Department of Medicine, Bowman Gray School of Medicine, Winston-Salem, NC 27103.
Brockschmidt
J K
JK
Muss
H B
HB
Saylor
G
G
D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011182:Postoperative Care / Q000379:methods*; D012307:Risk Factors