Chapter 086. Breast Cancer (Part 13) Follow-Up of Breast Cancer Patients Despite the availability of sophisticated and expensive imaging techniques and a wide range of serum tumor marker tests, survival is not influenced by early diagnosis of relapse. Surveillance guidelines are given in Table 86-5. Table 86-5 Breast Cancer Surveillance Guidelines Test Frequency Recommended History; eliciting symptoms; physical examination q3–6 months x 3 years; q6– 12 months x 2 years; then annually Breast self-examination Monthly Mammography Annually Pelvic examination Annually Patient education about symptoms of recurrence Ongoing Coordination of care Ongoing Not Recommended Complete blood count Serum chemistry studies Chest radiographs Bone scans Ultrasound examination of the liver Computed tomography of chest, abdomen, or pelvis Tumor marker CA 15-3, CA 27-29 Tumor marker CEA Source: Recommended Breast Cancer Surveillance Guidelines , ASCO Education Book, Fall, 1997. Further Readings Breast International Group (BIG) 1- 98 Collaborative Group: A comparison of letrozole and tamoxifen in postmenopausal women with early breast cancer. N Engl J Med 353:2747, 2005 Citron ML et al: Randomized trial of dose- dense versus conventionally scheduled and seque ntial versus concurrent combination chemotherapy as postoperative adjuvant treatment of node- positive primary breast cancer: First report of intergroup trial C9741/cancer and leukemia group B trial 9741. J Clin Oncol 21:1431, 2003 [PMID: 12668651] Cleator S et al: Triple- negative breast cancer: Therapeutic options. Lancet Oncol 8:235, 2007 [PMID: 17329194] Early Breast Cancer Trialists' Collaborative Group: Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15- year survival: An overview of the randomised trials. Lancet 365:1687, 2005 ——— : Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15- year survival: An overview of the randomised trials. Lancet 366:2087, 2005 Giordano S et al: Breast cancer in men. Ann Intern Med 137:678, 2002 [PMID: 12379069] Ingle JN et al: Fulvestrant in women with advanced breast cancer after progression on prior aromatase inhibitor therapy: North central cancer treatment group trial N0032. J Clin Oncol 24:1052, 2006 [PMID: 16505423] Jakesz R et al: Switching of postmenopausal women with endocrine- responsive early breast cancer to anastrozole after 2 years' adjuvant tamoxifen: Combined results of ABCSG trial 8 and ARNO 95 trial. Lancet 366:455, 2005 [PMID: 16084253] Partridge A, Schapira L: Pregnancy and breast cancer. Oncology 19:693, 2005 [PMID: 15971447] Romond EH et al: Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 353:1673, 2005 [PMID: 16236738] Santen RJ, Mansel R: Benign breast disorders. N Engl J Med 353:275, 2005 [PMID: 16034013] Shapiro CL, Winer EL (eds): Late effects of treatment and survivorship issues in early-stage breast cancer. Sem Oncol 30:729, 2003 Bibliography Berry DA: Benefits and risks of screening mammography for women in their forties: A statistical appraisal. J Natl Cancer Inst 90:1431, 1998 [PMID: 9776408] Braun S et al: A pooled analysis of bone marrow micrometastasis in breast cancer. N Engl J Med 353:793, 2005 [PMID: 16120859] Fyles AW et al: Tamoxifen with or without breast irradiation in women 50 years of age or older with early breast cancer. N Engl J Med 351:963, 2004 [PMID: 15342804] Harris J et al (eds): Diseases of the Breast. 3d ed. Philadelphia, Lippincott- Raven, 2004 Jones SE et al: Randomized phase III study of docetaxel compared with paclitaxel in metastatic breast cancer. J Clin Oncol 23:5542, 2005 [PMID: 16110015] Kendall A et al: Caution: Vaginal estradiol appears to be contraindicated in postmenopausal women on adjuvant aromatase inhibitors. Annals Oncol 17:584, 2006 [PMID: 16443612] Morrow M et al: Preoperative evaluation of abnormal mammographic findings to avoid unnecessary breast biopsies. Arch Surg 129:1091, 1 994 [PMID: 7944941] Oh DS et al: Estrogen- regulated genes predict survival in hormone receptor-positive breast cancers. J Clin Oncol 24:1656, 2006 [PMID: 16505416] Piccart- Gebhart M et al: Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med 353:1659, 2005 [PMID: 16236737] Ragaz J et al: Locoregional radiation therapy in patients with high- risk breast cancer receiving adjuvant chemotherapy: 20- year results of the British Columbia Randomized Trial. J Natl Cancer Inst 97:116, 2005 [PMID: 15657341] Roussouw JE et al: Risks and benefits of estrogen plus progestin in healthy postmenopausal women. JAMA 288:321, 2002 Rouzier R et al: Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res 11:5678, 2005 [PMID: 16115903] . Chapter 086. Breast Cancer (Part 13) Follow-Up of Breast Cancer Patients Despite the availability of sophisticated and expensive. primary breast cancer: First report of intergroup trial C9741 /cancer and leukemia group B trial 9741. J Clin Oncol 21:1431, 2003 [PMID: 12668651] Cleator S et al: Triple- negative breast cancer: . Oncol 8:235, 2007 [PMID: 17329194] Early Breast Cancer Trialists' Collaborative Group: Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15- year survival: