C. Omarini (Modena, Italy)
Azienda Ospedaliero - Universitaria Policlinico di ModenaAuthor Of 1 Presentation
137P - Survivorship care plan for breast cancer patients: an intensive follow-up is still useless?
Abstract
Background
Breast cancer (BC) survivors have health care needs including detection of early recurrences, treatment of therapy-related complications and psychological support. No randomized data exist to support any individual follow-up (FU) sequence or protocol. We investigated the survivorship care plan used at the Modena Cancer Center and its correlation to survival outcomes.
Methods
A retrospective review of all BC FU visits performed between 2015 and 2019 at the Modena Cancer Center was done. Data on BC FU care management were collected and correlated to survival outcomes. Overall survival (OS) was estimated by log-rank test and Kaplan-Meier curves.
Results
A total of 13685 BC FU visits were performed between 2015 and 2019. We detected 163 recurrences (1,91%): 123 were distant recurrences (75%) while 40 were loco-regional ones (25%). In particular, 69% in hormone receptor positive BC, 20% in HER2 positive BC and 11% in triple negative BC. Median OS (mOS) was 6 years (95% CI = 4 - 9), worse if compared to OS in patients relapsed after the end of the FU (mOS: 8 years, 95% CI = 5 - 19). Overall, patients who performed routinely screening procedures during the FU (i.e. tumor markers and/or imaging tests) had better mOS than those diagnosed due to clinical signs/symptoms (mOS: 8 years vs 3 years, respectively; p = 0,01). In particular, patients who underwent routine radiological examinations for distant recurrence detection (chest X-ray and liver ultrasound) had significantly longer mOS compared to patients with no routinary screening tests (mOS: 5 years vs 3 years, respectively; p = 0,007).
Conclusions
Although not recommended by international guidelines, intensive follow-up including routine radiological tests seems to improve OS in BC patients. The survival benefit could be justified by the significant recent improvement in metastatic BC management. Due to the retrospective and mono-institutional nature of this study, randomized clinical trials are needed.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.