Influence of early diagnosis on prognosis of recurrent breast cancer.

Between 1980 and 1986 676 patients with primary breast cancer were operated on with curative intention at the Department of Surgery, Hanusch Medical Center, Vienna, Austria. Of these, 133 had recurrences. The patients were closely followed at the Outpatient Clinic. The authors have retrospectively analyzed this patient collective to evaluate the impact of routine technical and laboratory-chemical follow-up programs on the detection rate of subclinical distant metastases and improvement of prognosis. There was no difference in outcome in terms of survival after recurrence and overall survival between patients with detection or recurrence in the asymptomatic stage who received general antitumoral therapy immediately, and a second group whose therapy was initiated upon clinical manifestation. The authors discuss the results in view of the screening costs. They emphasize the potential of follow-up programs due to timely detection of local recurrence, and observation of the contralateral breast, as well as the psychological aspect of a stable doctor-patient relationship.