title: Detection of bone metastases in routine follow-up after treatment for primary breast cancer.
abstract: OBJECTIVE
  The effect of follow-up after primary treatment for breast cancer on overall survival remains highly questionable, and controversy still exists regarding the benefits of regular follow-up. We therefore attempted to assess the role of intensive follow-up in patients with bone metastases.
  
  
  METHODS
  We analyzed the survival of 87 breast cancer patients who relapsed first in bone diagnosed either with or without symptoms, from 1985 to 1998. Overall survival (OS) was the main outcome. Recurrence was coded as either asymptomatic, elevated tumor marker, or symptomatic.
  
  
  RESULTS
  The median disease free interval was 33 months in the asymptomatic group, 42 months in the elevated tumor marker group, and 43 months in the symptomatic group. Overall survival did not differ significantly between the groups. The median OS was 77 months in the asymptomatic group, 78 months in the elevated tumor marker group, and 79 months in the symptomatic group.
  
  
  CONCLUSIONS
  Our study showed that intensive testing, including assessment of serum tumor markers and bone scans, did not improve OS. The results of our study supported the American Society of Clinical Oncology (ASCO) recommendations that routine use of bone scans is not recommended.
authors.affiliation: Department of Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Niigata, Niigata 951-8566, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Sato
authors.forename: Masato
authors.initials: M
authors.lastname: Hino
authors.forename: Muneaki
authors.initials: M
authors.lastname: Sano
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D001859:Bone Neoplasms / Q000401:mortality* / Q000556:secondary*; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor