Muss H B, McNamara M J, Connelly R A
Department of Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27103.
Am J Clin Oncol. 1988 Aug;11(4):451-5. doi: 10.1097/00000421-198808000-00008.
A retrospective study was undertaken to compare the frequency of scheduled and unscheduled (extra) visits and the signs and symptoms reported on such visits for 31 patients with relapse and 31 matched relapse-free patients all of whom had completed adjuvant treatment for stage II breast cancer. All patients had been treated with the same identical adjuvant therapy program and all had the same regular follow-up schedule, including clinic visits for history and physical examination every 6 months and chest x-ray, complete blood profile, bone scan, and mammogram yearly. Almost all (29/31) relapsed patients had signs or symptoms as the first indicator of recurrence. During a follow-up period of 13-16 months, the relapsed and nonrelapsed patients had a total of 89 and 81 visits, respectively, with an unscheduled visit occurring for almost every two routine visits. Almost all of the 89 total visits for relapsed patients and almost 75% for nonrelapsed patients were associated with signs or symptoms, a majority of which could have been due to cancer recurrence. We conclude that history and physical examination generally provide the first clues to recurrence but that such symptoms and signs are frequently reported by nonrelapsed patients as well as those with recurrence.
开展了一项回顾性研究，比较31例复发患者和31例配对的无复发患者的定期和不定期（额外）就诊频率，以及此类就诊时报告的体征和症状。所有这些患者均已完成II期乳腺癌的辅助治疗。所有患者均接受了相同的辅助治疗方案，并且都有相同的定期随访计划，包括每6个月进行一次病史和体格检查门诊，以及每年进行一次胸部X光、全血细胞检查、骨扫描和乳房X光检查。几乎所有（29/31）复发患者都有体征或症状作为复发的首个指标。在13至16个月的随访期内，复发患者和未复发患者分别进行了89次和81次就诊，几乎每两次常规就诊就会有一次不定期就诊。复发患者的89次就诊中几乎所有，以及未复发患者的近75%就诊都与体征或症状相关，其中大多数可能是由于癌症复发。我们得出结论，病史和体格检查通常能提供复发的首个线索，但此类症状和体征在未复发患者以及复发患者中均经常被报告。
