Chest radiography in the follow-up of breast cancer

The significance of routine chest radiography in the follow-up of breast cancer was evaluated. This evaluation also included correlation of symptoms with site of intrathoracic relapse. Ten per cent of the patients developed intrathoracic recurrence; 54 per cent thereof were asymptomatic. Eighty-six per cent of the intrathoracic relapses appeared within five years. The significance of prognostic factors was obvious: a higher stage or grade gave a higher risk of intrathoracic relapses. The presence of symptoms was dependent on the site of relapse. The disease-free survival and survival after recurrence were not significantly different in symptomatic and asymptomatic patients. The contribution of routine chest radiography to the detection of relapses in asymptomatic patients was poor: one positive finding among 263 chest radiographic examinations. Routine chest radiography should be limited to high risk groups (stage II, III and grade III), preferably within the first five years after the primary treatment.