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. 2022 Jun;17(3):249-256.
doi: 10.1159/000519533. Epub 2021 Nov 23.

Does Routine Follow-Up after Patients Have Completed Adjuvant Therapy for Early-Stage Breast Cancer at a Cancer Center Improve Prognosis?

Rikiya Nakamura  1 , Shouko Hayama  1 , Ryoutarou Etou  1 , Toshiko Miyaki  1 , Keiko Oshida  2 , Masaki Oshida  2 , Yashushi Itou  3 , Tetsumori Kou  4 , Naohito Yamamoto  1
Affiliations

Does Routine Follow-Up after Patients Have Completed Adjuvant Therapy for Early-Stage Breast Cancer at a Cancer Center Improve Prognosis?

Rikiya Nakamura et al. Breast Care (Basel). 2022 Jun.

Abstract

Introduction: This study aimed to assess whether follow-up of patients with operative breast cancer at cancer centres (CCs) improved prognosis compared with follow-up by family physicians (FPs).

Methods: The study included 254 patients who relapsed within 7 years from the first postoperative period. The patients were divided into two groups according to the follow-up facility: the CC and FP groups (the follow-up of patients was structured in the same way between FPs and CCs). There are 146 and 108 cases of recurrence in the CC and FP groups, respectively. The analysis targets of the two groups were determined using the propensity matching method based on the following 7 factors: oestrogen receptor status, progesterone receptor status, human epidermal growth factor receptor 2 status, St. Gallen category, menopausal status, surgical procedure, and receipt of postoperative chemotherapy at the time of surgery. Overall survival (OS) in both groups was analysed using the Kaplan-Meier method and compared using the log-rank test.

Results: Overall, 97 patients each in the CC and FP groups who relapsed were analysed using the propensity matching method. The median recurrence-free survival periods were 1,676 and 994 days in the FP and CC groups, respectively, and were significantly longer in the FP group. However, the median OS starting from the day of surgery was 3,424 and 2,794 days in the FP and CC groups, respectively, with no significant difference.

Conclusion: This study revealed that regular follow-up at CCs did not improve survival compared with regular follow-up by FPs.

Keywords: Breast cancer; Family physician; Routine follow-up.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
The flowchart of the examined target cases. FP, family physician; CC, cancer centre; ER, estrogen receptor; PgR, progesterone receptor; HER2, human epidermal growth factor receptor 2.
Fig. 2
Fig. 2
a The comparison of the overall survival (OS) curve after recurrence by the institution where recurrence was detected. b The comparison of the overall survival (OS) curve from the day of surgery by the institution. c The recurrence-free survival curve from breast cancer surgery to recurrence of invasive cancer in the two groups.
See this image and copyright information in PMC

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