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Patterns in detection of recurrence among patients treated for breast cancer

  • Clinical trial
  • Published:
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Abstract

Purpose

The Danish follow-up program for breast cancer (BC) patients has recently been changed. Today most patients are offered open access to an outpatient clinic, whereas the scheduled visits are phased out. This strategy has been studied in regards to psychological and health-related quality of life outcomes, but not in regards to detection of recurrence and survival. The aim of this study was to quantify the recurrences detected at scheduled outpatient visits in Denmark before the implementation of revised follow-up guidelines.

Methods

We conducted a cross-sectional study among 310 patients with recurrent BC. Information was retrieved on tumor characteristics, type of visit when recurrence was detected, recurrence localization, symptoms reported, and duration of symptoms from the Danish Breast Cancer Group database and medical records.

Results

The recurrences were locoregional (26%), locoregional and distant (15%), or distant (59%). Among patients still in outpatient follow-up (n = 199), recurrence was detected at a patient-requested extra outpatient visit (15%), by the general practitioner or other specialist (47%), at a scheduled outpatient visit (21%), or on a scheduled mammogram (11%). Among patients with recurrences detected at scheduled outpatient visits, the majority (88%) reported symptoms related to the recurrence. Most frequent symptoms were pain (37%), dyspnoea (15%), and fatigue (12%).

Conclusions

One-fifth of BC recurrences among patients attending outpatient follow-up were detected at scheduled outpatient visits. Very few of these were asymptomatic. Whether there will be a delay in detection of the symptomatic recurrences when the number of visits is reduced is unknown.

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Data availability

Data are available as presented in this paper. According to the Danish legislation, we are not allowed to make patient data available to other parties. The study group welcomes collaboration with other researchers using our data. Study protocols can be planned in collaboration with us, and the study material can be analyzed accordingly at the Danish Cancer Society Research Center in Copenhagen, Denmark.

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Acknowledgements

The authors thank all participants in the study. We are also grateful for the financial support we received to conduct the study from the Danish Cancer Society, Region Zealand, and Rigshospitalet.

Funding

This study was supported by the Danish Cancer Society (Grant No. DCS 12714019), Region Zealand, and Rigshospitalet, the two latter without grant numbers. These institutions funded the work, but they were not involved in designing the study; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

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Authors and Affiliations

  1. Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Lena Saltbæk, Trine Allerslev Horsboel, Anne Sofie Friberg & Susanne Oksbjerg Dalton

  2. Department of Oncology, Zealand University Hospital, Ringstedgade 61, 4700, Naestved, Denmark

    Lena Saltbæk & Susanne Oksbjerg Dalton

  3. Department of Experimental Clinical Oncology & Department of Oncology, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 99, 8200, Aarhus, Denmark

    Birgitte Vrou Offersen & Jens Overgaard

  4. Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Michael Andersson, Anne Sofie Friberg & Signe Korsgaard Skriver

  5. Psychological Aspects of Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Pernille Envold Bidstrup & Christoffer Johansen

  6. Institute of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen, Denmark

    Pernille Envold Bidstrup

  7. Late Effect Research Unit CASTLE, Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Christoffer Johansen

Authors
  1. Lena Saltbæk
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  2. Trine Allerslev Horsboel
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  3. Birgitte Vrou Offersen
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  4. Michael Andersson
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  6. Signe Korsgaard Skriver
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  7. Pernille Envold Bidstrup
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  8. Jens Overgaard
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  9. Christoffer Johansen
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  10. Susanne Oksbjerg Dalton
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Corresponding author

Correspondence to Lena Saltbæk.

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Conflicts of interest

All authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Danish Data Protection Agency (J.nr. 2015-41-4345). It was presented to the Committee on Health Research Ethics, and they confirmed that the study did not need their approval. The study was performed in accordance with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individual participants included in the study.

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Saltbæk, L., Horsboel, T.A., Offersen, B.V. et al. Patterns in detection of recurrence among patients treated for breast cancer. Breast Cancer Res Treat 184, 365–373 (2020). https://doi.org/10.1007/s10549-020-05847-4

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  • DOI: https://doi.org/10.1007/s10549-020-05847-4

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