Sauer H, Hölzel D
Medizinische Klinik III, Ludwig-Maximilians-Universität München.
Fortschr Med. 1995 May 10;113(13):183-7.
In the past, recommendations for the follow-up of women who had undergone primary treatment for local or locoregional breast cancer, were mostly concerned with "programmed" protocols in which the frequency of the follow-up appointments, and the examinations to be performed on the respective occasions (e.g. bone scintigraphy, chest X-ray, abdominal ultrasound, mammography and laboratory investigations) were rigidly fixed. Numerous new facts reported in the literature (including prospective randomized studies and meta-analyses) now appear to show that this formalized approach to follow-up brings the patient no advantage in terms of approved chances of being cured, longer survival or better quality of life. For this reason, for breast cancer follow-up, a strategy is proposed that is based on meticulous history-taking and clinical examination, and which also emphasizes psychosocial rehabilitation aspects. Examinations using technical equipment are carried out only when justified by clinical suspicion of recurrent disease.
过去,对于接受过局部或区域乳腺癌初始治疗的女性进行随访的建议,大多涉及“程序化”方案,其中随访预约的频率以及在相应时间进行的检查(如骨闪烁显像、胸部X线、腹部超声、乳房X线摄影和实验室检查)都有严格规定。文献中报道的众多新事实(包括前瞻性随机研究和荟萃分析)现在似乎表明,这种形式化的随访方法在已认可的治愈机会、更长生存期或更好生活质量方面并未给患者带来任何优势。因此,对于乳腺癌随访,提出了一种基于细致病史采集和临床检查的策略,该策略还强调心理社会康复方面。仅在临床怀疑疾病复发时有理由时才使用技术设备进行检查。