Follow-up after stage II breast cancer: a comparative study of relapsed versus nonrelapsed patients

A retrospective study was undertaken to compare the frequency of scheduled and unscheduled (extra) visits and the signs and symptoms reported on such visits for 31 patients with relapse and 31 matched relapse-free patients all of whom had completed adjuvant treatment for stage II breast cancer. All patients had been treated with the same identical adjuvant therapy program and all had the same regular follow-up schedule, including clinic visits for history and physical examination every 6 months and chest x-ray, complete blood profile, bone scan, and mammogram yearly. Almost all (29/31) relapsed patients had signs or symptoms as the first indicator of recurrence. During a follow-up period of 13-16 months, the relapsed and nonrelapsed patients had a total of 89 and 81 visits, respectively, with an unscheduled visit occurring for almost every two routine visits. Almost all of the 89 total visits for relapsed patients and almost 75% for nonrelapsed patients were associated with signs or symptoms, a majority of which could have been due to cancer recurrence. We conclude that history and physical examination generally provide the first clues to recurrence but that such symptoms and signs are frequently reported by nonrelapsed patients as well as those with recurrence.