Surveillance for Distant Metastasis in Breast Cancer Patients Who Underwent Contemporary Management: A Report from the Korean Breast Cancer Society Survivor Research Group

Jong-Ho Cheun ¹, Sooyeon Chung ², Jai Hong Han ³

¹Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.
²Department of Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, South Korea.
³Center for Breast Cancer, National Cancer Center, Goyang, South Korea.
⁴Department of Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, South Korea.
⁵Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
⁶Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
⁷Department of Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea.
⁸Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, South Korea.
⁹Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea.
¹⁰Department of Surgery, Chosun University Hospital, Chosun University College of Medicine, Gwangju, South Korea.
¹¹Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
¹²Department of Surgery, Gospel Hospital, Kosin University College of Medicine, Busan, South Korea.
¹³Department of Surgery, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, South Korea. yhj0903@chonbuk.ac.kr.
¹⁴Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. moonhg74@snu.ac.kr.

⁰Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.

Annals of Surgical Oncology +

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July 5, 2024

View abstract on PubMed

Summary

Intensive imaging for breast cancer metastasis detection may lead to earlier diagnosis but does not improve breast cancer-specific survival (BCSS). Current treatments are not enhanced by frequent surveillance imaging in asymptomatic patients.

Area Of Science

Oncology
Radiology
Clinical Medicine

Background

Current guidelines advise against routine imaging for metastasis in asymptomatic breast cancer patients.
Advancements in therapeutics and diagnostics necessitate re-evaluating intensive metastasis surveillance.
This study investigates the clinical efficacy of intensive imaging in detecting distant metastasis.

Purpose Of The Study

To investigate the association between intensive imaging studies and survival outcomes in breast cancer patients.
To determine if increased surveillance impacts distant metastasis-free survival and breast cancer-specific survival (BCSS).

Main Methods

Retrospective review of 4130 breast cancer patients from 11 Korean hospitals (2010-2011).
Patients categorized into high-intensive and low-intensity imaging groups based on physician decisions during the disease-free period.
Analysis included multivariable and propensity score matching.

Main Results

High-intensive screening correlated with earlier detection of distant metastasis, particularly to bone and lung (p < 0.001).
Poorer 5-year breast cancer-specific survival (BCSS) observed in the high-intensity group (p < 0.001).
No significant association found between screening intensity and BCSS in multivariable or propensity score matching analyses.

Conclusions

Intensive imaging facilitates earlier detection of distant metastasis, especially to bone and lung.
Despite earlier detection, intensive surveillance did not demonstrate an association with improved BCSS with current treatments.
Reassessment of current guidelines regarding intensive metastasis surveillance in asymptomatic breast cancer patients is warranted.

Keywords:

Breast cancer Distant metastasis Imaging study Mortality Surveillance