Prieto Marcela Martínez, de la Torre Celia B Flores, Basurto Carlos Sánchez, Forgach Ernesto Sánchez
Oncología médica, Centro Médico ABC, México.
Ginecol Obstet Mex. 2008 Feb;76(2):107-12.
Breast cancer is a frequent neoplasm in Latin America. Its control implies surveillance for about 10 years after diagnosis. The possibilities of metastatic disease depend on stage at diagnosis and the treatment administered to the patient. It is important that all medical centers implement their own follow-up that fits its needs. Surveillance must include physical therapy, attention to psychosocial aspects as well as treatment for toxicity, secondary effects, recurrence and second primaries. The American Society of Clinical Oncology (ASCO) includes monthly self-examination, annual mammography, office visits every three months for the first three years, and then biannual visits for the next two years and then annually. Randomized studies and the Cochrane database have proved that intensive follow-up is of no value compared with periodic appointments and annual mammography. Existing evidence suggests that postoperative surveillance of breast cancer patients is extremely expensive, time consuming and of no benefit in terms of survival. Most of recurrences present out of context from follow up visits. Thus, efficacy of routine doctor visits is questionable and a prospective study is needed to outline the adequate strategy.
乳腺癌在拉丁美洲是一种常见的肿瘤。对其进行控制意味着在诊断后进行约10年的监测。发生转移性疾病的可能性取决于诊断时的分期以及给予患者的治疗。所有医疗中心实施适合自身需求的随访很重要。监测必须包括物理治疗、关注心理社会方面以及对毒性、副作用、复发和第二原发肿瘤的治疗。美国临床肿瘤学会（ASCO）的方案包括每月自我检查、每年乳房X线摄影、头三年每三个月门诊就诊一次，接下来两年每半年就诊一次，然后每年就诊一次。随机研究和考克兰数据库已证明，与定期预约和每年乳房X线摄影相比，强化随访没有价值。现有证据表明，乳腺癌患者的术后监测极其昂贵、耗时，且对生存没有益处。大多数复发情况出现在随访就诊之外。因此，常规医生就诊的有效性值得怀疑，需要进行一项前瞻性研究来制定适当的策略。
