Muss H B, Tell G S, Case L D, Robertson P, Atwell B M
Cancer Center, Wake Forest University, Winston-Salem, N.C. 27103.
Am J Clin Oncol. 1991 Feb;14(1):55-9. doi: 10.1097/00000421-199102000-00013.
One hundred one patients with breast cancer, 48 localized and 53 metastatic, were questioned about their perceptions of follow-up examinations. Patients with metastatic disease preferred more frequent follow-up. Most indicated that they wanted their physicians to ask them about pain and nutritional status at each follow-up visit and were aware of the tests they had received. Only a third of the patients recognized the value of the history in detecting recurrence, and two-thirds felt that the physical examination was helpful. Laboratory tests and imaging procedures were rated higher than the history in detecting recurrence. Most patients were unaware of the implications of a normal procedure or test and perceived "normal" as meaning an absence of cancer cells in the organ evaluated. Knowledge of the value and limitations of testing was not related to educational level or disease stage. Patients need to be educated about the effectiveness of follow-up examination. Greater emphasis should be placed on the history and physical examination, and the limitations of more costly laboratory and imaging procedures should be explained carefully.
101例乳腺癌患者，其中48例为局限性癌，53例为转移性癌，就他们对随访检查的看法接受了询问。转移性疾病患者希望随访更频繁。大多数患者表示，他们希望医生在每次随访时询问他们的疼痛和营养状况，并且知道自己接受过哪些检查。只有三分之一的患者认识到病史在检测复发方面的价值，三分之二的患者认为体格检查有帮助。在检测复发方面，实验室检查和影像学检查的评分高于病史。大多数患者不了解正常检查或检测的意义，认为“正常”意味着在所评估的器官中没有癌细胞。对检查的价值和局限性的了解与教育水平或疾病阶段无关。需要对患者进行随访检查有效性方面的教育。应更加重视病史和体格检查，并仔细解释费用更高的实验室和影像学检查的局限性。
