title: Symptom-oriented follow-up of early breast cancer is not inferior to conventional control. Results of a prospective multicentre study.
abstract: 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.
authors.affiliation: Oncological Comprehensive Centre, Stuttgart, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Bornhak
authors.forename: Else
authors.initials: E
authors.lastname: Heidemann
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Herschlein
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Simon
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Merkle
authors.forename: Günter
authors.initials: G
authors.lastname: Widmaier
authors.forename: Rainer
authors.initials: R
authors.lastname: Ernst
authors.forename: Michael
authors.initials: M
authors.lastname: Greulich
authors.forename: Reinhard
authors.initials: R
authors.lastname: Bittner
authors.forename: Günther
authors.initials: G
authors.lastname: Kieninger
authors.forename: Peter
authors.initials: P
authors.lastname: Merkle
authors.forename: Helmut
authors.initials: H
authors.lastname: Strosche
authors.forename: Cornelius
authors.initials: C
authors.lastname: Karg
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wellhaeusser
authors.forename: Walter
authors.initials: W
authors.lastname: Aulitzky
authors.forename: Bernhardt
authors.initials: B
authors.lastname: Schmidt
authors.forename: Helmut
authors.initials: H
authors.lastname: Metzger
authors.forename: Meike
authors.initials: M
authors.lastname: Hahn
authors.forename: Anette
authors.initials: A
authors.lastname: Stauch
authors.forename: Christoph
authors.initials: C
authors.lastname: Meisner
authors.forename: Hans-Konrad
authors.initials: HK
authors.lastname: Selbmann
authors.forename: Christine
authors.initials: C
authors.lastname: Regelmann
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Brinkmann
mesh_terms: 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