Abstract
The surveillance of breast cancer patients after potentially curative treatment may result in the identification of locoregional or distant recurrence. While many patients expect frequent imaging studies to monitor for recurrence, there are no data supporting aggressive imaging surveillance beyond mammography. However, when recurrent disease is suspected, it is appropriate to undertake re-staging to develop a rational management plan. The rationale and methods for appropriate surveillance and re-staging are discussed.
Similar content being viewed by others
References
Loprinzi C. Follow-up care after breast cancer treatment. Mayo Clin Womens Healthsource. 2004;8:suppl 1–2.
de Bock GH, Bonnema J, Zwaan RE, van de Velde CJ, Kievit J, Stiggelbout AM. Patient’s needs and preferences in routine follow-up after treatment for breast cancer. Br J Cancer. 2004;90:1144–50.
Hess KR, Esteva FJ. Effect of HER2 status on distant recurrence in early stage breast cancer. Breast Cancer Res Treat. 2013;137:449–55.
Early Breast Cancer Trialists’ Collaborative G, Darby S, McGale P, Correa C, Taylor C, Arriagada R, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378:1707–16.
Veronesi U, Marubini E, Del Vecchio M, Manzari A, Andreola S, Greco M, et al. Local recurrences and distant metastases after conservative breast cancer treatments: partly independent events. J Natl Cancer Inst. 1995;87:19–27.
Wapnir IL, Anderson SJ, Mamounas EP, Geyer CE Jr, Jeong JH, Tan-Chiu E, et al. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in five National Surgical Adjuvant Breast and Bowel Project node-positive adjuvant breast cancer trials. J Clin Oncol. 2006;24:2028–37.
Anderson SJ, Wapnir I, Dignam JJ, Fisher B, Mamounas EP, Jeong JH, et al. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative breast cancer. J Clin Oncol. 2009;27:2466–73.
Janni W, Dimpfl T, Braun S, Knobbe A, Peschers U, Rjosk D, et al. Radiotherapy of the chest wall following mastectomy for early-stage breast cancer: impact on local recurrence and overall survival. Int J Radiat Oncol Biol Phys. 2000;48:967–75.
Halyard MY, Wasif N, Harris EE, Arthur DW, Bailey L, Bellon JR, et al. ACR Appropriateness Criteria(R) local-regional recurrence (LR) and salvage surgery: breast cancer. Am J Clin Oncol. 2012;35:178–82.
Schmoor C, Sauerbrei W, Bastert G, Schumacher M. Role of isolated locoregional recurrence of breast cancer: results of four prospective studies. J Clin Oncol. 2000;18:1696–708.
Khatcheressian JL, Hurley P, Bantug E, Esserman LJ, Grunfeld E, Halberg F, et al. Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:961–5.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Breast Cancer V.3.2013. © National Comprehensive Cancer Network, Inc 2013. All rights reserved. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc. www.nccn.org.
Palli D, Russo A, Saieva C et al. Intensive vs clinical follow-up after treatment of primary breast cancer: 10-year update of a randomized trial. National Research Council Project on Breast Cancer Follow-up. JAMA. 1999;281:1586.
Impact of follow-up testing on survival and health-related quality of life in breast cancer patients. A multicenter randomized controlled trial. The GIVIO Investigators. JAMA. 1994;271:1587–92.
Chlebowski RT, Geller ML. Adherence to endocrine therapy for breast cancer. Oncology. 2006;71:1–9.
Barron TI, Connolly R, Bennett K, Feely J, Kennedy MJ. Early discontinuation of tamoxifen: a lesson for oncologists. Cancer. 2007;109:832–9.
Rena O, Papalia E, Ruffini E, Filosso PL, Oliaro A, Maggi G, et al. The role of surgery in the management of solitary pulmonary nodule in breast cancer patients. Eur J Surg Oncol. 2007;33:546–50.
Abbott DE, Brouquet A, Mittendorf EA, Andreou A, Meric-Bernstam F, Valero V, et al. Resection of liver metastases from breast cancer: estrogen receptor status and response to chemotherapy before metastasectomy define outcome. Surgery. 2012;151:710–6.
Costelloe CM, Rohren EM, Madewell JE, Hamaoka T, Theriault RL, Yu TK, et al. Imaging bone metastases in breast cancer: techniques and recommendations for diagnosis. Lancet Oncol. 2009;10:606–14.
Disclosures
No financial disclosures
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Leitch, A.M. Management of Locoregional and Systemic Recurrence of Breast Cancer: To Stage or Not to Stage and How. Ann Surg Oncol 20, 3194–3198 (2013). https://doi.org/10.1245/s10434-013-3180-6
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1245/s10434-013-3180-6