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. PATIENTS AND 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). CONCLUSION: 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.
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. PATIENTS AND 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). CONCLUSION: 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: Achim Wöckel; Jasmin Festl; Tanja Stüber; Katharina Brust; Stephanie Stangl; Peter U Heuschmann; Ute-Susann Albert; Wilfried Budach; Markus Follmann; Wolfgang Janni; Ina Kopp; Rolf Kreienberg; Thorsten Kühn; Thomas Langer; Monika Nothacker; Anton Scharl; Ingrid Schreer; Hartmut Link; Jutta Engel; Tanja Fehm; Joachim Weis; Anja Welt; Anke Steckelberg; Petra Feyer; Klaus König; Andrea Hahne; Hans H Kreipe; Wolfram Trudo Knoefel; Michael Denkinger; Sara Brucker; Diana Lüftner; Christian Kubisch; Christina Gerlach; Annette Lebeau; Friederike Siedentopf; Cordula Petersen; Hans Helge Bartsch; Rüdiger Schulz-Wendtland; Markus Hahn; Volker Hanf; Markus Müller-Schimpfle; Ulla Henscher; Renza Roncarati; Alexander Katalinic; Christoph Heitmann; Christoph Honegger; Kerstin Paradies; Vesna Bjelic-Radisic; Friedrich Degenhardt; Frederik Wenz; Oliver Rick; Dieter Hölzel; Matthias Zaiss; Gudrun Kemper; Volker Budach; Carsten Denkert; Bernd Gerber; Hans Tesch; Susanne Hirsmüller; Hans-Peter Sinn; Jürgen Dunst; Karsten Münstedt; Ulrich Bick; Eva Fallenberg; Reina Tholen; Roswita Hung; Freerk Baumann; Matthias W Beckmann; Jens Blohmer; Peter A Fasching; Michael P Lux; Nadia Harbeck; Peyman Hadji; Hans Hauner; Sylvia Heywang-Köbrunner; Jens Huober; Jutta Hübner; Christian Jackisch; Sibylle Loibl; Hans-Jürgen Lück; Gunter von Minckwitz; Volker Möbus; Volkmar Müller; Ute Nöthlings; Marcus Schmidt; Rita Schmutzler; Andreas Schneeweiss; Florian Schütz; Elmar Stickeler; Christoph Thomssen; Michael Untch; Simone Wesselmann; Arno Bücker; Mathias Krockenberger Journal: Geburtshilfe Frauenheilkd Date: 2018-10-19 Impact factor: 2.915