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J Clin Oncol. 2007 Mar 20;25(9):1074-81.

Surveillance testing among survivors of early-stage breast cancer.

Author information

1
Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. keating@hcp.med.harvard.edu

Abstract

PURPOSE:

Guidelines recommend against routine surveillance testing for women who have had breast cancer. We described follow-up care for breast cancer survivors, examined how surveillance testing varies by the types of physicians seen, and assessed changes in testing rates over time.

METHODS:

Using Surveillance, Epidemiology, and End Results-Medicare data, we studied a population-based cohort of 44,511 women age > or = 65 years diagnosed with stage I/II breast cancer during 1992 to 1999 and observed through 2001. We measured bone scans, tumor antigen tests, chest x-rays, and other chest/abdominal imaging during 3 consecutive surveillance years. We described physicians seen in follow-up and used repeated-measures logistic regression to assess the relationship with testing and to assess testing trends over time.

RESULTS:

Nearly half of breast cancer survivors saw a medical oncologist in surveillance year 1, but only 27% saw a medical oncologist annually for 3 years. In adjusted analyses, women seeing medical oncologists had more bone scans, tumor antigen testing, chest x-rays, and chest/abdominal imaging than other women (all P < .001). Nevertheless, rates of testing decreased over time (all P < .001). Rates of tumor antigen testing and chest x-rays decreased faster and chest/abdominal imaging increased slower among women seeing medical oncologists than among other women (all P < .05).

CONCLUSION:

Non-recommended testing for early-stage breast cancer patients has decreased over time. Although most breast cancer survivors did not see oncologists annually, those who did had substantially higher rates of testing than others; whether such testing in this low-risk population was due to more symptoms or excessive surveillance is an important question for additional study.

PMID:
17369571
DOI:
10.1200/JCO.2006.08.6876
[Indexed for MEDLINE]
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