Martínez-Regueira F, Díez-Caballero A, Sierra A, Espí A, Baixauli J, Zornoza A
Dpto. Cirugía General, Facultad de Medicina, Universidad de Navarra.
Rev Med Univ Navarra. 1998 Jan-Mar;42(1):7-13.
Recurrence of breast cancer can present in very small tumors even 20 years after initial treatment. Periodic revision of all the operated population during a long time will be necessary to detect all the recurrences. For this the cost-benefit relation of follow-up in breast cancer is a controversial topic. We present our results in 750 cases of breast cancer operated from 1980 and submitted to a follow-up protocol during five years. We analyzed the value of follow-up for the discovery of metastases, local recurrence after conservative treatment and after mastectomy. Finally we considered the usefulness of early diagnosis of familial breast cancer and cancer in the contralateral breast. Metastases was discovered in asymptomatic patients in 68%, which could improve the survival. Recurrence after mastectomy was seen in 1.3% of the patient and a half of these after treatment presented survival superior to 3 years. Follow-up favours early diagnosis and could have influence on survival.
乳腺癌复发甚至可能出现在初始治疗20年后的极小肿瘤中。长期对所有接受手术的人群进行定期复查对于发现所有复发情况是必要的。为此，乳腺癌随访的成本效益关系是一个有争议的话题。我们呈现了1980年以来接受手术并在五年期间遵循随访方案的750例乳腺癌病例的结果。我们分析了随访对于发现转移、保乳治疗及乳房切除术后局部复发的价值。最后，我们考虑了家族性乳腺癌及对侧乳腺癌早期诊断的有用性。68%的无症状患者发现了转移，这可能改善生存率。乳房切除术后1.3%的患者出现复发，其中一半患者治疗后的生存时间超过3年。随访有利于早期诊断，并且可能对生存产生影响。
