Patterns in detection of recurrence among patients treated for breast cancer

Lena Saltbæk, Trine Allerslev Horsboel, Birgitte Vrou Offersen, Michael Andersson, Anne Sofie Friberg, Signe Korsgaard Skriver, Pernille Envold Bidstrup, Jens Overgaard, Christoffer Johansen, Susanne Oksbjerg Dalton

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

PURPOSE: The Danish follow-up program for breast cancer (BC) patients has recently been changed. Today most patients are offered open access to an outpatient clinic, whereas the scheduled visits are phased out. This strategy has been studied in regards to psychological and health-related quality of life outcomes, but not in regards to detection of recurrence and survival. The aim of this study was to quantify the recurrences detected at scheduled outpatient visits in Denmark before the implementation of revised follow-up guidelines.

METHODS: We conducted a cross-sectional study among 310 patients with recurrent BC. Information was retrieved on tumor characteristics, type of visit when recurrence was detected, recurrence localization, symptoms reported, and duration of symptoms from the Danish Breast Cancer Group database and medical records.

RESULTS: The recurrences were locoregional (26%), locoregional and distant (15%), or distant (59%). Among patients still in outpatient follow-up (n = 199), recurrence was detected at a patient-requested extra outpatient visit (15%), by the general practitioner or other specialist (47%), at a scheduled outpatient visit (21%), or on a scheduled mammogram (11%). Among patients with recurrences detected at scheduled outpatient visits, the majority (88%) reported symptoms related to the recurrence. Most frequent symptoms were pain (37%), dyspnoea (15%), and fatigue (12%).

CONCLUSIONS: One-fifth of BC recurrences among patients attending outpatient follow-up were detected at scheduled outpatient visits. Very few of these were asymptomatic. Whether there will be a delay in detection of the symptomatic recurrences when the number of visits is reduced is unknown.

Original languageEnglish
JournalBreast Cancer Research and Treatment
Volume184
Issue number2
Pages (from-to)365-373
ISSN0167-6806
DOIs
Publication statusPublished - Nov 2020
Externally publishedYes

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