Evaluation of follow-up methods to detect relapse after mastectomy in breast cancer patients

Summary

ARETROSPECTIVE assessment of follow-up methods after mastectomy for operable breast cancer was carried out in 84 patients. Forty-two patients have had recurrence of breast cancer, one patient developed a second primary and 41 patients remain free of disease. Patient symptomatology gave first evidence in 24 (57.1%) patients who relapsed. Physical examination in asymptomatic patients gave first evidence of relapse in 12 patients (28.5%). Serial measurements of carcinoembryonic antigen, alkaline phosphatase and erythrocyte sedimentation rate during the disease-free interval were more commonly abnormal in the patients who suffered a relapse than in those who remained disease free. In the recurrence group 14 of 18 patients (77.7%) had at least one blood test abnormal during the disease-free interval compared to 14 of 36 (38.8%) of patients who remained disease free, x² = 7.27, D.F. = I, p<0.01. Isotopie bone scans and chest x-rays (C.X.R.s) at approximately yearly intervals detected only 11.9% and 2.3% of patients with relapse respectively in the absence of abnormal clinical features or blood tests.