[Follow-up of breast carcinoma]

The rationalization of the follow-up schedule for patients treated for breast cancer appears essential due to the high incidence of this disease. The authors retrospectively analyze their series (3,596 patients, from 1971 to 1990) to assess the patterns of both early loco-regional recurrences and distant metastases. Patterns and outcome of local and regional recurrences are reported according to site. The international literature on the subject is reviewed, and the schedule currently employed in the follow-up of breast cancer patients at the Radiotherapy Unit of Florence is reported. Due to the patterns of relapse a more intensive clinical follow-up schedule is suggested during the first 5 years. Less intensive follow-up continues over the whole patients' life span, since failures can occur even after 5 years. Mammography should be repeated every year in the same period to detect eventual homolateral and/or contralateral relapses. Other diagnostic tools should be employed only when symptoms set in. On the ground of the current literature on the subject, no negative impact on survival should be expected from this follow-up schedule.