Mammography
and Physical Examination Both Important in Detecting Recurrences
in Early Breast Cancer
According to results recently presented at the 45th annual
meeting of the American Society for Therapeutic Radiation
and Oncology, the combination of mammography and physical
examination is important in detecting cancer recurrences in
the same breast, as well as cancers in the opposite breast
in women diagnosed with stages I-II breast cancer.
Stages I and II breast cancers are considered early breast
cancers and have a high rate of a cure following standard
treatment regimens. Stage I breast cancer refers to cancer
that is less than 2 cm and has not spread to axillary (under
the arm) lymph nodes or other areas of the body. Stage II
breast cancer refers to cancer that is less than 5 cm and
has spread to axillary lymph nodes, or is greater than 2 cm
and has not spread to axillary lymph nodes. Standard treatment
for stages I-II breast cancer is typically breast conservation
treatment (removal of the cancer from the breast), followed
by radiation with or without chemotherapy. Following treatment,
however, some women still experience a cancer recurrence in
the same breast, or another cancer in the other breast. It
is important to detect and treat these cancers as early as
possible, to ensure optimal chances of a cure.
Researchers from the University of Pennsylvania recently
evaluated data from 1,379 patients who had been diagnosed
with stages I or II breast cancer between 1977 and 1995. These
patients had been treated with breast conservation therapy
and followed with physical examination of the breast as well
as annual mammography of both breasts. The rate of recurrence
within the same breast occurred in 125 patients and the rate
of cancer in the opposite breast occurred in 71 patients.
Recurrences within the same breast were detected by mammography
only in 38% of cases, by physical exam only in 37%, and by
both mammography and physical exam in 25% of cases. Breast
cancer occurring in the opposite breast was detected in 53%
of patients with mammography only, in 23% by physical exam
only, and in 24% by both mammography and physical exam. Approximately
half of the patients with a recurrence in the same breast
or a diagnosis of cancer in the opposite breast had this occur
within 5 years of the initial diagnosis, and half had this
occur later than 5 years from initial diagnosis.
The researchers concluded that these results indicate that
both mammography and physical examination of both breasts
are important in detecting cancer recurrences within the same
breast, or cancer in the opposite breast, in patients initially
diagnosed with stages I-II breast cancer. Furthermore, it
is important that both of these detection methods are approached
as long-term screening procedures, as approximately half of
local cancer recurrences and cancers occurring in the opposite
breast were detected at 5 years or longer following initial
diagnosis. Patients who have been diagnosed with stages I
or II breast cancer should discuss annual mammography an physical
examination schedules with their physician.
Reference: Chen C, Harris E, Orel S, Solin L. The role of
mammography and physical examination in detecting recurrent
tumor an contralateral breast cancer for patients with stage
I-II breast cancer treated with breast conservation treatment.
Proceedings from the 45th annual meeting of the American Society
for Therapeutic Radiation and Oncology. October 2003. Abstract
#13. S131.
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