Follow-up of breast cancer patients.

Follow-up of patients with breast cancer is often pursued in an irregular, haphazard, and costly way. For patients who have had potentially curative treatment for localized breast cancer, effort should be concentrated for the life time of the patient on early detection of persistent or new breast cancers, and early detection of endometrial and large bowel cancers in order to maximize the chance of cure. The patient-physician interaction is the dominant factor in such follow-up. Bone and other scans and carcinoembryonic antigen levels do not detect curable disease, so these are not indicated for routine follow-up of patients with early stage disease. For patients with metastasis, follow-up has a different emphasis and is geared to defining the extent and activity of metastasis and early detection of treatable complications so as to optimize palliation. For all patients it is necessary to continually evaluate their social and emotional requirements and to evaluate the family for risk of cancer and other problems. A follow-up team, led by the physician, is required to best fulfill these multiple needs.