Kim Ku Sang, Kim Zisun, Shim Eun-Jung, Kim Nam Hyoung, Jung So-Youn, Kim Jisun, Sohn Guiyun, Lee Jong Won, Cho Jihyoung, Lee Jung Eun, Lee Juhyung, Youn Hyun Jo, Lee Jihyoun, Lee Min Hyuk
Department of Surgery, Breast-Thyroid Center, Ulsan City Hospital, Ulsan, Korea.
Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
Ann Surg Treat Res. 2015 Mar;88(3):133-9. doi: 10.4174/astr.2015.88.3.133. Epub 2015 Feb 27.
Follow-up after primary treatment for breast cancer is an important component of survivor care and various international guidelines exist for the surveillance. However, little is known about current actual practice patterns of physicians whether they adhere to or deviate from recommended guidelines. The aim of this study was to determine how physicians follow-up their patients after primary treatment for breast cancer in Korea.
A questionnaire survey with 34 questions in 4 categories was e-mailed to the members of Korean Breast Cancer Society from November to December 2013. Respondents were asked how they use follow-up modalities after primary treatment of breast cancer and we compared the survey results with present guidelines.
Of the 129 respondents, 123 (95.3%) were breast surgeons. The most important consideration in follow-up was tumor stage. History taking, physical examinations, and mammography were conducted in similar frequency recommended by other guidelines while breast ultrasonography was performed more often. The advanced imaging studies such as CT, MRI, and bone scan, which had been recommended to be conducted only if necessary, were also examined more frequently. Regular screenings for secondary malignancy were performed in 38 respondents (29.5%). Five years later after primary treatment, almost the whole respondents (94.6%) themselves monitored their patients.
A majority of respondents have been performed more intensive follow-up modalities in comparison with present guidelines and less frequently screenings for secondary malignancy. For optimal follow-up of breast cancer survivors, tailored delivery system should be considered.
乳腺癌初次治疗后的随访是幸存者护理的重要组成部分,并且存在各种国际监测指南。然而,对于医生目前的实际实践模式,即他们是遵循还是偏离推荐指南,了解甚少。本研究的目的是确定韩国医生在乳腺癌初次治疗后如何对患者进行随访。
2013年11月至12月,通过电子邮件向韩国乳腺癌协会成员发送了一份包含4个类别34个问题的问卷调查。询问受访者在乳腺癌初次治疗后如何使用随访方式,并将调查结果与当前指南进行比较。
在129名受访者中,123名(95.3%)是乳腺外科医生。随访中最重要的考虑因素是肿瘤分期。病史采集、体格检查和乳房X线摄影的进行频率与其他指南推荐的相似,而乳房超声检查的进行频率更高。推荐仅在必要时进行的CT、MRI和骨扫描等高级影像学检查,其检查频率也更高。38名受访者(29.5%)进行了继发性恶性肿瘤的定期筛查。初次治疗五年后,几乎所有受访者(94.6%)都自行对患者进行监测。
与当前指南相比,大多数受访者采用了更强化的随访方式,而继发性恶性肿瘤的筛查频率较低。为了对乳腺癌幸存者进行最佳随访,应考虑量身定制的递送系统。