Mammogram and Doctor Visits Enough for Follow-Up -- MEDICA - World Forum for Medicine

The report suggests that more intensive lab tests like liver scans and molecular tumour markers do not improve the chances of detecting a recurrence of cancer or increase survival rates among former breast cancer patients.

The finding is at odds with the usual treatment for breast cancer patients, according to Dr. Roldano Fossati of the Mario Negri Institute in Italy and colleagues. "Intensive follow-up is quite common in clinical practice and represents a significant workload for radiotherapy, surgical and oncologic departments,” says Fossati.

The current review includes four randomised controlled trial studies of 3,055 patients that compare different types of breast cancer follow-up care. After analysing data from two of the studies, the researchers found no significant difference in terms of survival, detection of new cancers or quality of life between a group of women who got regular physical exams and annual mammograms and a group who underwent a more extensive battery of laboratory tests that included liver scans, molecular tumour markers, chest x-rays and blood and liver function tests.

Another study included in the review found that follow-up care by hospital specialists was not significantly different from that offered by general practitioners in terms of improvements in the patient's quality of life or speed in detecting new cancers.

Despite studies indicating that routine physical exams are effective follow-up care, the National Cancer Institute's treatment recommendations to health professionals notes that "the appropriateness of screening tests after the completion of primary treatment remains controversial.”

Although evidence favouring less intensive follow-up care began to appear in the late 1990s, "women still seemed to prefer a frequent schedule of tests in order to be reassured about their health status,” Fossati says.; Source: The Cochrane Library