Umbach G E, Holzki C, Perschmann U, Schnürch H G, Bender H G
Universitäts-Frauenklinik Düsseldorf.
Geburtshilfe Frauenheilkd. 1988 May;48(5):292-8. doi: 10.1055/s-2008-1026505.
We retrospectively analyzed methods of follow-up and subsequent clinical outcome in 399 breast cancer patients treated with curative intent. Radioisotope liver scans, liver sonograms and laboratory investigations were of little value in detecting metastases. Mammography detected 2 of 6 contralateral breast cancers in an asymptomatic stage. Of 92 metastatic diseases, 24 were disclosed by a total of 871 radioisotope bone scans, and 17 were disclosed by a total of 2409 chest x-rays. The detection of distant metastases in an asymptomatic stage by diagnostic procedures vs detection by symptoms was not correlated with a survival benefit. The survival times for the two groups were 6.4 years vs 6.7 years (p = 0.7) after initiation of primary therapy, and 20.8 vs 20.4 months (p = 0.9) after the diagnosis of metastatic disease. Our study does not lend support to the hypothesis that the detection of metastatic disease in an asymptomatic stage or regular follow-up visits are associated with a survival benefit. We conclude that clinical history, physical examination, and mammography are the most important procedures in the follow-up of breast cancer patients.
我们回顾性分析了399例接受根治性治疗的乳腺癌患者的随访方法及后续临床结局。放射性核素肝脏扫描、肝脏超声检查和实验室检查在检测转移方面价值不大。乳腺X线摄影在无症状阶段检测出6例对侧乳腺癌中的2例。在92例转移性疾病中,871次放射性核素骨扫描共发现24例,2409次胸部X线检查共发现17例。通过诊断程序在无症状阶段检测远处转移与通过症状检测相比,与生存获益无关。两组在开始初始治疗后的生存时间分别为6.4年和6.7年(p = 0.7),在诊断为转移性疾病后的生存时间分别为20.8个月和20.4个月(p = 0.9)。我们的研究不支持无症状阶段检测转移性疾病或定期随访与生存获益相关的假说。我们得出结论,临床病史、体格检查和乳腺X线摄影是乳腺癌患者随访中最重要的检查。