Cancer Res Treat.  2015 Oct;47(4):765-773. 10.4143/crt.2014.168.

Impact on Survival of Regular Postoperative Surveillance for Patients with Early Breast Cancer

• Lee JY
• Lim SH
• Lee MY
• Kim H
• Kim M
• Kim S
• Jung HA
• Sohn I
• Gil WH
• Lee JE
• Kim SW
• Nam SJ
• Ahn JS
• Im YH
• Park YH

• KMID: 2403395
• DOI: http://doi.org/10.4143/crt.2014.168

Abstract

PURPOSE
The purpose of this study is to evaluate the role of regular postoperative surveillance to improve the prognosis of patients with breast cancer after curative surgery.
MATERIALS AND METHODS
We retrospectively analyzed the medical records of 4,119 patients who received curative surgery for breast cancer at Samsung Medical Center between January 2000 and September 2008. Patients were divided into two groups (group I, regular postoperative surveillance; group II, control group) according to their post-therapy follow-up status for the first 5 years after surgery.
RESULTS
Among the 3,770 patients selected for inclusion, groups I and II contained 3,300 (87%) and 470 (13%) patients, respectively. The recurrence rates at 5 years for groups I and II were 10.6% and 16.4%, respectively (hazard ratio, 0.85; 95% confidence interval [CI], 0.67 to 1.09; p=0.197). The 10-year mortality cumulative rates were 8.8% for group I and 25.4% for group II (hazard ratio, 0.28; 95% CI, 0.22 to 0.35; p < 0.001). In multivariate analysis for recurrence-free survival (RFS), age over 40 years (p < 0.001), histologic grade 1 (p < 0.001), and pathologic stage I (p < 0.001) were associated with longer RFS but not with follow-up status. Multivariate analysis for overall survival (OS) revealed that patients in group I showed significantly improved OS (hazard ratio, 0.29; 95% CI, 0.23 to 0.37; p < 0.001). Additionally, age over 40 years, histologic grade I, and pathologic stage I were independent prognostic factors for OS.
CONCLUSION
Regular follow-up for patients with breast cancer after primary surgery resulted in clinically significant improvements in patient OS.

Keyword

Breast neoplasms; Epidemiology; Recurrence

MeSH Terms

Breast Neoplasms*
Breast*
Epidemiology
Follow-Up Studies
Humans
Medical Records
Mortality
Multivariate Analysis
Prognosis
Recurrence
Retrospective Studies

Figure

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  Fig. 1. Patient cohort. SMC, Samsung Medical Center; DCIS, ductal carcinoma in situ; LCIS, lobular carcinoma in situ; Op, operation.

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  Fig. 2. Kaplan-Meier curves for recurrence-free survival (A), overall survival (B), and overall survival for patients with recurrence (C) according to follow-up status. CI, confidence interval.

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  Fig. 3. Subgroup analysis of overall survival. CI, confidence interval; HR, hormone receptor; HER2, human epidermal growth factor receptor 2; IDC, invasive ductal carcinoma.

Reference

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