CLINICAL AND MAMMOGRAPHY FOLLOW-UP OF BREAST-CANCER AFTER CONSERVATIVE TREATMENT

Clinical and mammographic follow-up of 149 patients diagnosed of stage I and II breast neoplasm and treated with conservative surgery and ir radiation between January 1986 and December 1988 was reviewed to deter mine clinical and radiographic recurrence pattern. Follow-up controls included a clinical examination and a mammogram at 6-9 months, a secon d at 10-16, a third at 17-22, a fourth at 23-24 and a mammogram yearly and a clinical examination every 6 months thereafter. To December 199 1 18 patients recurred. 12 had a metastatic spread, 3 a unique local r ecurrence and 3 a local recurrence with a metastatis spread. Clinical recurrence was as a carcinomatous mastitis in three patients and a sol id nodule in two. Radiologic recurrence was as an augmented skin thick ness in three patients. Mammogram was not performed in one patient bec ause an associated poor prognostic metastatic spread. Mammographic ski n thickness secondary to irradiation appeared in 93% of the patients a t 6-9 first control, 62% at second, 50% at third and 35% at fourth. Th e number of recurrences is scarce to achieve any clinical, pathologica l or treatment factor associated with greater risk of recurrence. We s uggest that first mammogram should be delayed after 12 months of treat ment because we would not obtain any relevant clinical information bef ore, once observed skin thickness persistence at 6 months and most fre quent recurrence radiologic pattern.