Br Med J (Clin Res Ed) 1985;291:1464-1467 (23 November), doi:10.1136/bmj.291.6507.1464
Value of routine follow up of women treated for early carcinoma of the breast.
The value of routine follow up of women treated for early breast
cancer by mastectomy with or without postoperative radiotherapy
was assessed retrospectively. Over eight years 546 patients
made 6863 clinic visits, during which 192 first relapses were
detected. Ninety three relapses were detected at scheduled (routine)
visits and 99 at unscheduled (interval) visits. First relapses
within the treated area or in the contralateral breast were
detected significantly more commonly at routine visits than
were first metastatic relapses (66/89 (74%) compared with 27/103
(26%)). Patients whose local relapse was detected at a routine
visit had a significantly better survival than those whose local
relapse was detected at an interval visit. A relapse that was
potentially curable (local or in the contralateral breast) was
detected at 66 (1%) of 6764 routine visits, but only 26 (39%)
of these patients remained free of disease. It is concluded
that the intensity of follow up of such patients could be reduced
without any adverse effect on prognosis but with appreciable
financial and other benefits.

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