Which lab and imaging studies are recommended for the routine comprehensive care of a woman with a history of breast cancer who underwent lumpectomy 10-15 years earlier? How frequently should the studies be done?—DAWN GIORGIO, RPA-C, Bronx, N.Y.
Most patients who experience breast cancer recurrence do so within the first decade after diagnosis, with the rate of relapse peaking between two and five years after initial diagnosis. Estimates of late mortality are 2% per year beginning 15 years after primary treatment. Postoperative surveillance strategies for the detection and treatment of recurrent breast cancer vary. In recent years, the efficacy of intensive surveillance with laboratory and imaging studies has been reviewed to determine if this testing improves survival and/or results in improved quality of life. The available data support a conservative rather than aggressive approach to breast cancer follow-up. Routine laboratory and radiographic testing (with the exception of mammography) are no longer recommended. A woman who underwent a lumpectomy 10-15 years earlier would follow the same recommendations for periodic health examinations as any other woman her age (Semin Oncol. 2003;30:338-348).—JoAnn Deasy, PA-C, MPH (144-10)