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Follow-up in breast cancer: does routine clinical examination improve outcome? A systematic review of the literature

Multiple guidelines exist for the follow-up of breast cancer, with no agreement on frequency or duration. The contribution of routine clinical examination for the detection of potentially treatable relapse, and the impact this has on survival, is unknown. In this study, we systematically review the...

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Autores principales: Montgomery, D A, Krupa, K, Cooke, T G
Formato: Texto
Lenguaje:English
Publicado: Nature Publishing Group 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360278/
https://www.ncbi.nlm.nih.gov/pubmed/18000508
http://dx.doi.org/10.1038/sj.bjc.6604065
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author Montgomery, D A
Krupa, K
Cooke, T G
author_facet Montgomery, D A
Krupa, K
Cooke, T G
author_sort Montgomery, D A
collection PubMed
description Multiple guidelines exist for the follow-up of breast cancer, with no agreement on frequency or duration. The contribution of routine clinical examination for the detection of potentially treatable relapse, and the impact this has on survival, is unknown. In this study, we systematically review the literature to establish the proportion of potentially treatable locoregional relapses and new contralateral breast cancers detected by clinical examination, mammography and patient self-examination. We analyse whether method of detection of relapse influences outcome. The methods used were systematic review of the literature. MEDLINE, EMBASE, CancerLit, Web of Sciences and EBM reviews were the data sources for the systematic review. All studies with information on proportion of relapses detected by clinical examination, mammography and self-examination were included. A total of 30–40% of potentially treatable relapses are detected by patient self-examination. In studies published before 2000, 15% of such relapse is mammographically detected with 46% detected by routine clinical examination. In those published after 2000, 40% are mammographically detected with 15% detected on routine clinical examination. Patients with ipsilateral breast relapse detected clinically appear to do less well than those with relapse detected by self-examination or mammography. Routine clinical surveillance is responsible for detection of fewer potentially treatable relapses in more modern cohorts as experience with mammography increases. There is no evidence to suggest that clinical examination confers a survival advantage compared with other methods of detection. The data in this analysis suggest that a review of the guidelines on follow-up after breast cancer should be undertaken.
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spelling pubmed-23602782009-09-10 Follow-up in breast cancer: does routine clinical examination improve outcome? A systematic review of the literature Montgomery, D A Krupa, K Cooke, T G Br J Cancer Clinical Study Multiple guidelines exist for the follow-up of breast cancer, with no agreement on frequency or duration. The contribution of routine clinical examination for the detection of potentially treatable relapse, and the impact this has on survival, is unknown. In this study, we systematically review the literature to establish the proportion of potentially treatable locoregional relapses and new contralateral breast cancers detected by clinical examination, mammography and patient self-examination. We analyse whether method of detection of relapse influences outcome. The methods used were systematic review of the literature. MEDLINE, EMBASE, CancerLit, Web of Sciences and EBM reviews were the data sources for the systematic review. All studies with information on proportion of relapses detected by clinical examination, mammography and self-examination were included. A total of 30–40% of potentially treatable relapses are detected by patient self-examination. In studies published before 2000, 15% of such relapse is mammographically detected with 46% detected by routine clinical examination. In those published after 2000, 40% are mammographically detected with 15% detected on routine clinical examination. Patients with ipsilateral breast relapse detected clinically appear to do less well than those with relapse detected by self-examination or mammography. Routine clinical surveillance is responsible for detection of fewer potentially treatable relapses in more modern cohorts as experience with mammography increases. There is no evidence to suggest that clinical examination confers a survival advantage compared with other methods of detection. The data in this analysis suggest that a review of the guidelines on follow-up after breast cancer should be undertaken. Nature Publishing Group 2007-12-17 2007-11-13 /pmc/articles/PMC2360278/ /pubmed/18000508 http://dx.doi.org/10.1038/sj.bjc.6604065 Text en Copyright © 2007 Cancer Research UK https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.
spellingShingle Clinical Study
Montgomery, D A
Krupa, K
Cooke, T G
Follow-up in breast cancer: does routine clinical examination improve outcome? A systematic review of the literature
title Follow-up in breast cancer: does routine clinical examination improve outcome? A systematic review of the literature
title_full Follow-up in breast cancer: does routine clinical examination improve outcome? A systematic review of the literature
title_fullStr Follow-up in breast cancer: does routine clinical examination improve outcome? A systematic review of the literature
title_full_unstemmed Follow-up in breast cancer: does routine clinical examination improve outcome? A systematic review of the literature
title_short Follow-up in breast cancer: does routine clinical examination improve outcome? A systematic review of the literature
title_sort follow-up in breast cancer: does routine clinical examination improve outcome? a systematic review of the literature
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360278/
https://www.ncbi.nlm.nih.gov/pubmed/18000508
http://dx.doi.org/10.1038/sj.bjc.6604065
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