Follow-up of patients with localized breast cancer and first indicators of advanced breast cancer recurrence: A retrospective study

Breast. 2017 Aug:34:53-57. doi: 10.1016/j.breast.2017.05.005. Epub 2017 May 12.

Abstract

We conducted a retrospective study to assess the follow-up of patients with localized breast cancer and the first indicators of advanced breast cancer recurrence. All patients with advanced breast cancer recurrence treated between January 2010 and June 2016 in our institution were registered. Among these patients, 303 patients initially treated for early breast cancer with curative intent were identified. After initial curative treatment, follow-up involved the oncologist, the general practitioner and the gynecologist in 68.0%, 48.9% and 19.1% of cases, respectively. The median DFI was 4 years for luminal A, 3.8 years for luminal B, 3.7 years for HER2-positive and 1.5 years for TNBC (p = 0.07). Breast cancer tumor marker was prescribed for 164 patients (54.1%). No difference in terms of follow-up was observed according to the molecular subtype. Symptoms were the primary indicator of relapse for 143 patients (47.2%). Breast cancer recurrence was discovered by CA 15.3 elevation in 57 patients (18.8%) and by CAE elevation in 3 patients (1%). The rate of relapse diagnosed by elevation of CA 15.3 or CAE was not statistically associated with the molecular subtype (p = 0.65). Luminal A cases showed a significantly higher rate of bone metastases (p = 0.0003). TNBC cases showed a significantly higher rate of local recurrence (p = 0.002) and a borderline statistical significant higher rate of lung/pleural metastases (p = 0.07). Follow-up recommendations could be adapted in clinical practice according to the molecular subtype. General practitioners should be more involved by the specialists in breast cancer follow-up.

Keywords: Breast cancer; Diagnosis; Follow-up; Recurrence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood
  • Bone Neoplasms / diagnosis*
  • Bone Neoplasms / secondary
  • Breast Neoplasms / blood
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / pathology
  • Central Nervous System Neoplasms / diagnosis*
  • Central Nervous System Neoplasms / secondary
  • Connexins / blood*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / secondary
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / secondary
  • Lymphatic Metastasis
  • Magnetic Resonance Imaging
  • Mammography
  • Middle Aged
  • Mucin-1 / blood*
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / diagnosis*
  • Retrospective Studies
  • Triple Negative Breast Neoplasms / blood
  • Triple Negative Breast Neoplasms / diagnosis
  • Triple Negative Breast Neoplasms / pathology

Substances

  • Biomarkers, Tumor
  • Connexins
  • Mucin-1
  • connexin 50