Preoperative and follow‐up procedures on patients with breast cancer

From July 1, 1975 to June 30, 1979, 194 patients were enrolled in a program under a contract from the NCI to study chemoimmunotherapy in patients with Stage II and Stage III breast cancer. Patients were treated in six-week cycles for one year and were later followed at six month intervals. Pretreatment evaluation included complete blood count, SMA-12, xerogram, chest x-ray, and bone scan. The blood count and SMA-12 were repeated every six weeks before each course of treatment, and all of the preoperative tests were repeated at the completion of one year of treatment. After the year of treatment, testing was variable depending upon the stage of the disease, the patient's symptoms, and the individual preferences of the responsible physician. Up to the present time, there have been 38 recurrences in the 194 patients entered into this protocol. Twenty-nine of the recurrences were symptomatic at the time of discovery, four were asymptomatic and detected on physical examination, and five asymptomatic recurrences were detected by routine testing. Review of 60 patients who developed recurrence during approximately the same interval but who were not on the protocol shows that 43 were symptomatic and 14 were discovered on routine physical examination; 3 patients were asymptomatic. During this time, five new breast cancers were discovered in patients included in this report. Three were discovered by xerogram and two by physical examination. Further studies need to be made to provide sound data for optimal follow-up procedures on previously treated breast cancer patients. Careful history, physical examination, and evaluation of symptoms will identify most recurrences at a relatively early stage and extensive routine testing may not be worthwhile.