SURVEY OF THE PRACTICE OF FOLLOW-UP FOR THE EARLY DETECTION OF DISTANT METASTASES IN BREAST-CANCER PATIENTS IN EUROPE

Data on the current follow-up policy for breast cancer patients were p rovided by 55 European (EU = 66348 patients) and 83 Italian (IT = 2763 7 patients) centres adhering to two parallel surveys. Chest X-ray (EU = 73%, IT = 78%) and biological markers (EU = 71%, IT = 83%) were more commonly used than bone scintigraphy (EU = 56%, IT = 60%) and liver u ltrasonography (EU = 65%, IT 71%). The interval between repeat testing was shorter for biological markers (3-6 months; EU = 64%, IT = 91%) a nd longer for bone scans (12 months; EU = 77%, IT = 96%), yet about do uble with respect to currently reported estimates of detection lead ti me. The use of follow-up testing for asymptomatic meta stases was sign ificantly less common in larger centres. Although at least one repeat test was routinely performed in most centres (EU = 87%, IT = 94%), a r elevant proportion of centres believed that follow-up has no impact on prognosis (EU = 36%, IT = 53%), or on quality of Life (EU = 40%, IT = 43%), and adds no further information to that known of the natural hi story of the disease (EU = 75%, IT = 65%). This discrepancy suggests t hat recent controlled studies showing that breast cancer follow-up for early detection of distant metastases is not worthwhile have contribu ted to a progressive change in our understanding, but a much slower ch ange in follow-up protocols.