Ellegaard Mai-Britt Bjørklund, Grau Cai, Zachariae Robert, Jensen Anders Bonde
Department of Oncology, Aarhus University Hospital, Nørrebrogade 44 - Building 5, 8000, Aarhus C, Denmark.
Psycho-Oncological Research Unit, Aarhus University Hospital, Aarhus C, Denmark.
Breast Cancer Res Treat. 2017 Aug;164(3):727-736. doi: 10.1007/s10549-017-4301-x. Epub 2017 May 23.
Follow-up after breast cancer treatment is standard due to the risk of development of new primary cancers and recurrent disease. The aim of the present study was to evaluate a standard follow-up program in an oncological department by assessing: (1) Symptoms or signs of new primary cancer or recurrent disease, (2) Disease- and treatment-related physical and psychosocial side or late effects, and (3) relevant actions by oncology staff.
In a cross-sectional study, 194 women who came for follow-up visit after treatment for primary surgery were included. The clinical oncologists registered symptoms and signs of recurrent disease or new primary cancer. Side or late effects were both assessed by patient and the clinical oncologists.
Loco-regional or distant signs of recurrent disease were suspected in eight (5%) patients. Further examinations revealed no disease recurrence. Most patients (93%) reported some degree of side or late effects. Statistically significant more side or late effects were reported by the women (average: 6.9) than registered by the clinical oncologists (average: 2.4), p < 0.001. The three most often patient-reported side or late effects were hot flushes (35%), fatigue (32%), and sleep disturbance (31%).
None of the scheduled or additional visits resulted in detection of recurrent disease. Furthermore, the majority of patients reported side or late effects. Statistically significant more women reported side or late effects than registered by the clinical oncologists. This suggests the need for rethinking of the follow-up programs with more emphasis upon side or late effects of the treatment.
由于存在发生新原发性癌症和疾病复发的风险，乳腺癌治疗后的随访是标准流程。本研究的目的是通过评估以下内容来评价肿瘤科室的标准随访计划：（1）新原发性癌症或复发性疾病的症状或体征；（2）与疾病和治疗相关的身体及心理社会方面的副作用或晚期效应；（3）肿瘤科室工作人员的相关行动。
在一项横断面研究中，纳入了194名接受原发性手术后前来进行随访的女性。临床肿瘤学家记录复发性疾病或新原发性癌症的症状和体征。副作用或晚期效应由患者和临床肿瘤学家共同评估。
8名（5%）患者疑似存在局部区域或远处复发性疾病的体征。进一步检查未发现疾病复发。大多数患者（93%）报告有一定程度的副作用或晚期效应。女性报告的副作用或晚期效应（平均：6.9）在统计学上显著多于临床肿瘤学家记录的数量（平均：2.4），p < 0.001。患者报告最多的三种副作用或晚期效应是潮热（35%）、疲劳（32%）和睡眠障碍（31%）。
无论是预定的还是额外的随访均未检测到复发性疾病。此外，大多数患者报告有副作用或晚期效应。在统计学上，报告副作用或晚期效应的女性显著多于临床肿瘤学家记录的数量。这表明需要重新思考随访计划，更加重视治疗的副作用或晚期效应。
