Winchester D P, Sener S F, Khandekar J D, Oviedo M A, Cunningham M P, Caprini J A, Burkett F E, Scanlon E F
Cancer. 1979 Mar;43(3):956-60. doi: 10.1002/1097-0142(197903)43:3<956::aid-cncr2820430326>3.0.co;2-l.
Eighty-seven patients with recurrent breast cancer after mastectomy were analyzed for patterns of recurrence and methods of detection. After an average disease-free interval of 30 months, 38% developed osseous metastases, 16% recurred locally, 10% had local plus systemic disease, 10% showed pulmonary metastases and the remainder were distributed among liver, brain, and remaining breast disease. In 79 patients recurrence was heralded by symptoms. Physical examination in five asymptomatic patients revealed local or supraclavicular recurrence. In only three asymptomatic patients was recurrence documented by "routine" chest x-rays (in two), or liver enzymes/liver scan (in one). No asymptomatic disease was found by bone scan. It is concluded that periodic history, physical examination, and chest x-rays are the most important components in the follow-up of breast cancer patients. Radioisotope scans and other radiographs are valuable in confirming symptomatic disease and detecting additional diseases, but cannot be recommended routinely in the asymptomatic patient because of low yield and cost.
对87例乳房切除术后复发性乳腺癌患者的复发模式及检测方法进行了分析。在平均30个月的无病间隔期后，38%发生骨转移，16%局部复发，10%为局部加全身病变，10%出现肺转移，其余分布在肝脏、脑及残留乳腺病变。79例患者有症状预示复发。5例无症状患者经体格检查发现局部或锁骨上复发。仅3例无症状患者通过“常规”胸部X光片（2例）或肝酶/肝脏扫描（1例）记录到复发。骨扫描未发现无症状疾病。结论是，定期病史、体格检查和胸部X光片是乳腺癌患者随访中最重要的组成部分。放射性核素扫描和其他X光片在确诊有症状疾病及检测其他疾病方面有价值，但由于检出率低和成本高，不建议对无症状患者进行常规检查。
