Bell R J, Fradkin P, Robinson P J, Schwarz M, Davis S R
Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Intern Med J. 2014 Apr;44(4):332-8. doi: 10.1111/imj.12205.
Although there is evidence that minimal surveillance is compatible with an optimal outcome in women after early stage breast cancer, little is known of the surveillance that these women receive.
To describe the intended clinical follow up and patterns of use of imaging modalities in low-risk breast cancer survivors who are at least 5 years from diagnosis.
Participants in the Bupa Health Foundation Health and Wellbeing After Breast Cancer Study with stage 1 invasive breast cancer at diagnosis, who had survived free of recurrence or new primary breast cancer for at least 5 years, provided information for this analysis.
The most common choice of physician follow up was with one doctor only (54%). Within this group, the most frequent choice was a general practitioner (GP) (63%) followed by medical oncologist (23%). Thirty-five per cent of women said that they intended to consult two doctors and within this group, the most common combination was a GP and a medical oncologist (45%). This was despite two out of three women reporting being advised that there was no need to consult a medical oncologist. Over 90% of women reported having a mammogram with, or without, breast ultrasound in the previous 12 months. There was a low rate of use of other imaging tests in the absence of clear indications.
Minimising unnecessary medical consultations by women with breast cancer at low risk of recurrence 5 years from diagnosis will require education about the benefits of a minimal surveillance strategy.
尽管有证据表明,早期乳腺癌女性进行最低限度的监测也能取得最佳结果,但对于这些女性所接受的监测情况却知之甚少。
描述诊断后至少5年的低风险乳腺癌幸存者的预期临床随访情况及成像模态的使用模式。
参与保柏健康基金会乳腺癌研究后健康与幸福项目的患者,诊断时为1期浸润性乳腺癌,且无复发或新发原发性乳腺癌存活至少5年,为本次分析提供了信息。
医生随访最常见的选择是仅由一名医生进行(54%)。在这一组中,最常选择的是全科医生(63%),其次是医学肿瘤学家(23%)。35%的女性表示她们打算咨询两名医生,在这一组中,最常见的组合是全科医生和医学肿瘤学家(45%)。尽管三分之二的女性报告称曾被告知无需咨询医学肿瘤学家。超过90%的女性报告在过去12个月内进行了乳房X光检查,无论是否进行了乳房超声检查。在没有明确指征的情况下,其他成像检查的使用率较低。
对于诊断后5年复发风险较低的乳腺癌女性,要减少不必要的医疗咨询,需要开展关于最低限度监测策略益处的教育。