Post-treatment Follow up of Primary Breast Cancer (I), Survey among members of The Korean Breast Cancer Society

Nam, Jung Hyun; Jung, Pa Jong

Abstract

Periodic examination of patients after potentially curative treatment for breast cancer is routine practice. The objectives of such follow up are 1) surveillance for cancer recurrence 2) monitoring for toxicities related to therapy 3) maximizing overall health and quality of life for cancer survivors. However, recent literatures suggest that routine intensive follow up studies for asymptomatic breast cancer patients after primary treatments, showed no survival benefit. Also, there is controversy between aggressive and minimal policy for breast cancer patients follow up after primary treatment still exist. We administrated a mailed survey to The Korea Breast Cancer Society (KBSC) members (N=136,1996) to study the methods of preoperative evaluation and post-treatment follow up, as practicing in Korea and determine whether an accepted standard exists, or whether difference in practice occurred, base on physicians factors (years of physician experience, age of physician, number of breast cancer treated annually, practice type). The survey response yield was 45.59% (62/136), and mean age of the respondent was 43.7 years (range 33-67). There was roughly equal distribution of respondents by region (capital/noncapital area:27/31), and practice type (university hospital/general hospital: 37/21). The average practice in breast disease treatment of respondents (most of them were surgeon: N=57) was 8 years, and breast-conserving rate of respondents in 1996 was 210.2%. The considerable factors in follow up practice were 1) stage, 2) symptoms, 3) age, 4) operation methods, 5) demand of patient, 6) education level of patient in orders. Most frequently used tests for intial work up and base line follow up study for breast cancer patient were history, physical examination, mammography, breast US, chest X-ray, bone scan, FNA, open biopsy, CBC/ ESR, SMA, CEA, CA15-3 respectively. In this study, we proposed the model of breast cancer follow up which is practicing among the KBCS members and also we concluded as follows 1) This follow up model is more aggressive than other foreign cancer center follow up protocol 2) The KBCS members survey for non-breast cancer second malignancy less frequently than others 3) It seems to need concensus conference for Korea guideline model of breast cancer follow up.