Chest X-ray survey in the follow-up of breast cancer patients.
The authors report on 182 cases of intrathoracic metastases (ITM = lung, pleura or mediastinum) observed as first single recurrences in the course of the follow-up of patients treated for primary breast cancer. ITM were detected on standard two-views chest X-ray (CXR) at regular follow-up visits and in absence of subjective symptoms (102 A cases) or in the interval between two consecutive planned controls because of the onset of subjective symptoms (80 S cases). The average disease-free interval since primary treatment was significantly shorter in A with respect to S cases (40.3 vs. 28.5 months, P less than 0.001) as a consequence of the early detection achieved by CXR survey. On the contrary, prognosis was not influenced by ITM early diagnosis as the 10-year survival since primary treatment did not differ significantly between A or S cases (12% vs. 10%, P = 0.68). Results were confirmed on multivariate (Cox's) analysis, adjusting for potential confounders such as age or nodal status. Periodic CXR survey looks a very questionable policy as it does not seem to have any favourable impact on prognosis. Its routine use in breast cancer patients should thus be carefully reconsidered.
Ciatto
S
S
Centro per lo Studio e la Prevenzione Oncologica, Firenze, Italy.
Pacini
P
P
Andreoli
C
C
Cecchini
S
S
Iossa
A
A
Grazzini
G
G
Buranelli
F
F
Campa
T
T
Costa
A
A
Magni
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*