BMJ 1996;313:1548 (14 December)

Letters

Most recurrences after breast conservation are detected by regular hospital visits

EDITOR,--Eva Grunfeld and colleagues state that most recurrences of breast cancer (18 out of 25) were detected by the women themselves between routine visits.1 One must be clear why patients with breast cancer have regular follow up. It is not to detect metastatic disease, as there is clear evidence that early detection and treatment of such disease do not produce benefits.2 The aim is to detect local recurrence so that treatment can be introduced at a stage that optimises the probability of maintaining long term locoregional control.

We have recently reviewed recurrences occurring in the breast after treatment by wide local excision and radiotherapy. In a series of 55 patients 10 such recurrences were detected by patients themselves, 23 by regular clinical examination in our follow up clinic, and 22 by annual mammography. Recurrences detected by patients were larger than those in the two other groups. Of the 23 detected . . . [Full text of this article]


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Relevant Article

Routine follow up of breast cancer in primary care: randomised trial
Eva Grunfeld, David Mant, Patricia Yudkin, Ruth Adewuyi-Dalton, David Cole, Jill Stewart, Ray Fitzpatrick, and Martin Vessey
BMJ 1996 313: 665-669. [Abstract] [Full Text]

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