ASCO guidelines on BC surveillance

celinelvr

While reading the post on psychosocial issues of BC, I had more questions. I went to the American Society of Clinical Oncology to look up the guidelines on BC surveillance. My onc never told me anything more than I needed a mam twice a year for the next 2 years.

This is what I found:

American Society of Clinical Oncology 2006 Update of the Breast Cancer Follow-up and Management Guideline in the Adjuvant Setting



James L. Khatcheressian, Antonio C. Wolff, Thomas J. Smith, Eva Grunfeld, Hyman B. Muss, Victor G. Vogel, Francine Halberg, Mark R. Somerfield, and Nancy E. Davidson for the American Society of Clinical Oncology Breast Cancer Surveillance Expert

Purpose: To update the 1999 American Society of Clinical Oncology (ASCO) guideline on breast cancer follow-up and management in the adjuvant setting.

Methods: An ASCO Expert Panel reviewed pertinent information from the literature through March 2006. More weight was given to studies that tested a hypothesis directly relating testing to one of the primary outcomes in a randomized design.

Results: The evidence supports regular history, physical examination, and mammography as the cornerstone of appropriate breast cancer follow-up. All patients should have a careful history and physical examination performed by a physician experienced in the surveillance of cancer patients and in breast examination. Examinations should be performed every 3 to 6 months for the first 3 years, every 6 to 12 months for years 4 and 5, and annually thereafter. For those who have undergone breast-conserving surgery, a post-treatment mammogram should be obtained 1 year after the initial mammogram and at least 6 months after completion of radiation therapy. Thereafter, unless otherwise indicated, a yearly mammographic evaluation should be performed. Patients at high risk for familial breast cancer syndromes should be referred for genetic counseling. The use of CBCs, chemistry panels, bone scans, chest radiographs, liver ultrasounds, computed tomography scans, [18F]fluorodeoxyglucose-positron emission tomography scanning, magnetic resonance imaging, or tumor markers (carcinoembryonic antigen, CA 15-3, and CA 27.29) is not recommended for routine breast cancer follow-up in an otherwise asymptomatic patient with no specific findings on clinical examination.

Conclusion: Careful history taking, physical examination, and regular mammography are recommended for appropriate detection of breast cancer recurrence.

I say we need to educate OURSELVES on the symptoms of mets ... brain, lung, liver, bone, etc.. to watch out for these ourselves. I found my lump myself - I don't trust my Dr to look out for me. WOMEN HAVE TO ADVOCATE FOR THEMSELVES! Everyone from my previous $)@#&@ boss to the car dealer -(not even my husband)> I have ALWAYS had the feeling that NO ONE was listening to ME!

~ Milly

mmontero38

I agree with you Milly. We
I agree with you Milly. We need to look out for ourselves and if our doctors don't suggest any of these guidelines then we should be the ones requesting them. No one knows our bodies better than ourselves. Hugs, lili

kat8674

I was early stage, ERP, no
I was early stage, ERP, no lymph node involvement. I was never talked to about symptoms of mets and was told I was at a low risk.9 years later (2008) after years of back problems, upper, middle and lower it was finally diagnosed as metastatic breast cancer in my spine. I was miss diagnosed twice and I had to keep pushing for answers. Sure wish he would have done a bone scan or MRI as a follow up 5 years after the first diagnosis. And now I am still in the same boat. Back to a routine care plan and no information on what to watch out for next! And there will be a next time!

So I agree ladies!! We need to educate ourselves.

phoenixrising

This is a good article
This is a good article Milly, thank you. There doesn't seem to be one protocol that all oncs follow. It varies betw states and here in provinces. So this gives us all a base guideline as to what we should be expecting. Here in B.C., cancer protocols are the same throughout the province which is nice. Whether you live in Vancouver or the far north, tx is the same.

You know, my docs, in defence of our protocols don't want to do extensive testing like tumour markers, pet scans because they say it doesn't prolong survival time. But I can't help thinking that the smaller the tumour, the easiest to treat. And by the time I'm symptomatic it could be everywhere. Perhaps I don't know the issues well enough. But yes, we need to educate ourselves about everything (it seems).
love
jan

rjjj

phoenixrising said:

This is a good article
This is a good article Milly, thank you. There doesn't seem to be one protocol that all oncs follow. It varies betw states and here in provinces. So this gives us all a base guideline as to what we should be expecting. Here in B.C., cancer protocols are the same throughout the province which is nice. Whether you live in Vancouver or the far north, tx is the same.

You know, my docs, in defence of our protocols don't want to do extensive testing like tumour markers, pet scans because they say it doesn't prolong survival time. But I can't help thinking that the smaller the tumour, the easiest to treat. And by the time I'm symptomatic it could be everywhere. Perhaps I don't know the issues well enough. But yes, we need to educate ourselves about everything (it seems).
love
jan

I agree
We do need to be our own advocate. Wouldn't it be nice if they gave us a care-plan? Maybe some do but i don't know many. Dr.'s are so busy now,, but i really think more time spent on tests and preventative issues, would give us more peace. knowing that we will be reminded when and what we need to do would be very comforting. It gets overwhelming trying to keep track of everything by yourself.
Sometimes they are even to busy to concentrate on other areas the CA could reoccur..My mom had colin cancer and they neglected to tell her that there were visible signs on an xray for lung ca. we didn't even know it until she developed a cough that would not go away. I know they miss things and this is very scary to me.
I work at a hosp. (although it is not a cancer center) and know that we have care-plans for each one, but i also know that alot of the time there is frustration with plans not being carried through.
I feel it would be ideal for all parties involved to take part in our care-plans. It is alot of work but i will be on top of my own. I don't trust anyone with my own preventative plan but myself and God. Thanks for the article. It is nice to have guidelines to look at.
God Bless
Jackie