Puglisi Fabio, Fontanella Caterina, Numico Gianmauro, Sini Valentina, Evangelista Laura, Monetti Francesco, Gori Stefania, Del Mastro Lucia
Department of Oncology, University Hospital of Udine, Italy; Department of Medical and Biological Sciences, University of Udine, Italy.
Department of Oncology, University Hospital of Udine, Italy.
Crit Rev Oncol Hematol. 2014 Aug;91(2):130-41. doi: 10.1016/j.critrevonc.2014.03.001. Epub 2014 Mar 22.
The guidelines for follow-up in breast cancer survivors support only performance of periodic physical examination and annual mammography. However, medical oncologists and primary care physicians routinely recommend both blood tests and non-mammographic imaging tests in asymptomatic patients, leading to an increased anxiety related to false-positive results and higher medical expenses. Recently, advanced imaging technologies have improved sensitivity/specificity to detect metastatic lesions before symptoms arise. Considering the progress made in the treatment of metastatic disease and the rapid evolution of targeted therapy, that requires customization of the strategy according to molecular characteristics of the disease, patients could derive real benefit to early detection of disease recurrence. This hypothesis must be tested in a prospective clinical trial.
乳腺癌幸存者的随访指南仅支持定期体格检查和每年进行乳腺钼靶检查。然而，肿瘤内科医生和初级保健医生通常会建议对无症状患者进行血液检查和非乳腺钼靶成像检查，这导致与假阳性结果相关的焦虑增加以及医疗费用升高。最近，先进的成像技术提高了在症状出现前检测转移病灶的敏感性/特异性。考虑到转移性疾病治疗取得的进展以及靶向治疗的快速发展，这需要根据疾病的分子特征定制策略，患者可能会从疾病复发的早期检测中真正受益。这一假设必须在前瞻性临床试验中进行检验。
