Park Sungmin, Moon Hyeong-Gon, Lee Jong Won, Kim Ku Sang, Kim Zisun, Jung So-Youn, Lee Jihyoun, Lee Se Kyung, Chae Byung Joo, Jung Sung Ui, Chun Jung Whan, Cheun Jong-Ho, Youn Hyun Jo
Department of Surgery, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, Korea.
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
J Breast Cancer. 2024 Aug;27(4):235-247. doi: 10.4048/jbc.2023.0234.
This study evaluated the effectiveness of different surveillance intensities on morbidity and mortality in women with breast cancer.
This retrospective study included patients who had undergone breast cancer surgery in the Republic of Korea between 2009 and 2011. The patients were divided into two groups based on the intensity of their postsurgical surveillance: intensive surveillance group (ISG) and less-intensive surveillance group. Surveillance intensity was measured based on the frequency and type of follow-up diagnostic tests conducted, including mammography, ultrasonography, computed tomography, magnetic resonance imaging, bone scans, and positron emission tomography scans.
We included 1,356 patients with a median follow-up period of 121.2 months (range, 12.8-168.0 months). The analysis revealed no significant difference in the overall survival (OS) between the two groups within five years of surgery. However, patients with ISG exhibited significantly better breast cancer-specific survival (BCSS) and distant metastasis-free survival (DMFS) within the same period. Five years after surgery, the differences in survival outcomes between the groups were not statistically significant.
Intensive surveillance did not demonstrate a significant improvement in OS for patients with breast cancer beyond five years postoperatively. However, within the first five years, intensive surveillance was associated with better BCSS and DMFS. These findings suggest that personalized surveillance strategies may benefit specific patient subsets, particularly in the early years after treatment. Further nationwide randomized studies are warranted to refine surveillance guidelines and optimize outcomes in patients with breast cancer.
本研究评估了不同监测强度对乳腺癌女性发病率和死亡率的影响。
这项回顾性研究纳入了2009年至2011年在韩国接受乳腺癌手术的患者。根据术后监测强度将患者分为两组：强化监测组（ISG）和低强度监测组。监测强度根据所进行的随访诊断测试的频率和类型来衡量，包括乳房X线摄影、超声检查、计算机断层扫描、磁共振成像、骨扫描和正电子发射断层扫描。
我们纳入了1356例患者，中位随访期为121.2个月（范围12.8 - 168.0个月）。分析显示，两组在手术后五年内的总生存期（OS）无显著差异。然而，同期强化监测组患者的乳腺癌特异性生存期（BCSS）和无远处转移生存期（DMFS）显著更好。手术后五年，两组生存结果的差异无统计学意义。
强化监测在乳腺癌患者术后五年以上并未显示出总生存期的显著改善。然而，在头五年内，强化监测与更好的乳腺癌特异性生存期和无远处转移生存期相关。这些发现表明，个性化监测策略可能使特定患者亚组受益，尤其是在治疗后的早期。有必要进行进一步的全国性随机研究，以完善监测指南并优化乳腺癌患者的治疗结果。
