Symptom-oriented follow-up of early breast cancer is not inferior to conventional control. Results of a prospective multicentre study.
BACKGROUND
The homogeneity of the schemes for follow-up care after curative surgical treatment of early breast cancer is still a matter of debate in Germany. We investigated whether symptom-oriented follow-up is equivalent in terms of survival rates to conventional surveillance based on scheduled tests.


METHODS
In a prospective, non-randomised, multicentre cohort study carried out between 1995 and 2000, 244 patients underwent a conventional follow-up (scheduled laboratory tests including CEA and CA 15-3, chest X-rays and liver ultrasound). 426 patients were monitored in a symptom-oriented manner (additional tests only in the case of symptoms indicating possible recurrence). Mammography, structured histories and physical examinations were done regularly in both branches. 1,108 patients did not participate in the project. They represent 'real world patients', unaffected by the implications of a study.


RESULTS
The symptom-oriented follow- up group produced results not inferior to those of the intensive one (p < 0.05) in terms of overall and relapse-free survival. Furthermore, no difference was indicated in terms of overall survival between study participants and the 'real world patients' (p = 0.316).


CONCLUSIONS
The results confirm that regular imaging and laboratory tests have no relevant effect on overall survival of patients after curative primary therapy of early breast cancer and support the implementation of a symptom-oriented routine follow-up.
Bornhak
Sven
S
Oncological Comprehensive Centre, Stuttgart, Germany.
Heidemann
Else
E
Herschlein
Hans-Joachim
HJ
Simon
Wolfgang
W
Merkle
Elisabeth
E
Widmaier
Günter
G
Ernst
Rainer
R
Greulich
Michael
M
Bittner
Reinhard
R
Kieninger
Günther
G
Merkle
Peter
P
Strosche
Helmut
H
Karg
Cornelius
C
Wellhaeusser
Ulrich
U
Aulitzky
Walter
W
Schmidt
Bernhardt
B
Metzger
Helmut
H
Hahn
Meike
M
Stauch
Anette
A
Meisner
Christoph
C
Selbmann
Hans-Konrad
HK
Regelmann
Christine
C
Brinkmann
Friedhelm
F
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome