Detection of metachronous breast carcinoma: the role of follow-up?

Second primary (metachronous) breast carcinoma occurs at a rate of approxim ately 1% per year. Early detection of metachronous carcinomas will optimise the chances of curative treatment. The aim of this study was to identify t he method of detection of metachronous carcinomas, so that efforts to detec t these tumours can be made more focused. Thirteen patients presented twice to a surgical department in a 7-year peri od with second primary breast carcinomas. The means of detection of the sec ond primary carcinoma was identified in each case. Eleven of the patients presented with new symptoms which they had noticed t hemselves. The remaining two carcinomas were detected mammographically, and their presence was confirmed on clinical examination. In no case was the s econd primary carcinoma detected by clinical examination alone. Metachronous carcinoma is unlikely to be detected by routine clinical exami nation, but rapid assessment of new symptoms should be facilitated. Follow- up mammography at regular intervals should also improve early detection of metachronous breast carcinoma.