Methods for detecting locally recurrent and contralateral second primary breast cancer.

The author has studied the roles of thermography, mammography and breast self-examination in detecting recurrent primary cancer or a second primary in the contralateral breast. Of 273 patients whose primary cancer was treated by lumpectomy, recurrence developed in 52 (19%); 51 were detected on clinical examination and 1 by mammography alone. None were detected by thermography alone. Of the 51 patients with a local recurrence detected clinically, 35 had undergone repeat mammography before biopsy. A change suggestive of a malignant condition was noted in only 15 (43%). Thirty-seven had adequately stable postoperative thermograms for review. Only 9 (25%) of these thermograms showed a change in pattern before or at the time the recurrence was detected. Similar results were found in the detection of a secondary primary in the contralateral breast in these patients and also in a further 193 women whose primary cancers were treated by total mastectomy during the same period. Close clinical supervision is the most efficient method of detecting local recurrence and contralateral second primary breast cancer.