[Effect of early diagnosis on the prognosis of metastatic breast cancer].

Between 1980 and 1986 676 patients with primary breast cancer were operated on with curative intent at the Department of Surgery of the Hanusch Hospital in Vienna. Of these 133 developed recurrences. The patients were closely followed up at our outpatient clinic. We have retrospectively analysed this patient collective to evaluate the impact of routine technical and chemical-pathological follow-up programmes on the detection rate of subclinical distant metastases and on improvement of prognosis. There was no difference in the outcome with respect to survival after recurrence and to overall survival between patients with early detection of recurrence at an asymptomatic stage, who received general antitumor therapy immediately and a second group where therapy was initiated only upon clinical manifestation of metastasis. The results are discussed in relationship to screening costs. We would like to emphasize the importance of follow-up programmes in the timely detection of local recurrence and also of cancer of the contralateral breast, as well as benefitting the psychological aspect of the doctor-patient relationship.