Assessing Detection Modalities for Breast Cancer Recurrence

Ali Duffens, MD, San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, discusses the relative effectiveness of different detection modalities in identifying breast cancer recurrences.

These findings come from a study that analyzed a cohort of 4431 women diagnosed with stages I to III invasive breast cancer from the Kaiser Permanente Northern California Health System. Detection methods included in the study were patient-reported symptoms, surveillance mammogram, diagnostic testing, routine clinical breast exam, or incidental findings.

Here, Duffens also expands on the notable differences in detection rates and outcomes based on patient demographics or initial cancer characteristics.

Transcription:

0:09 | The study revealed that patient-reported symptoms were the most common modality for detecting recurrence, accounting for 69.4% of cases. Routine mammograms detected 8.1% of recurrences, diagnostic testing identified 10.9%, and physician exams were only 6.8%. Incidental findings accounted for 4.5% of recurrences. This low yield of clinical breast exams and surveillance suggests that it might not be the most effective method for detecting asymptomatic recurrence, and the limitations of clinical breast exams are attributed to factors such as the clinician skill, the patient's body habitus, and the tumor's location and characteristics.

0:57 | The differences in detection rates were observed based on patient demographics and cancer characteristics. Younger patients and those with higher BMI had slightly higher recurrence rates. Additionally, although it was not published in this abstract, we plan to publish in the upcoming paper [that] recurrences were more common in patients with positive nodal status than diagnosis and higher tumor grade. These factors highlight the need for more research to explore tailored surveillance strategies based on initial tumor and staging characteristics.

REFERENCE:

Duffens A, Laurent C, Roh JM, et al. Evaluating the utility of routine survivorship exams in breast cancer: Modality of detection of recurrence in a prospective cohort study. J Clin Oncol. 2024;42 (suppl 16):1629. doi:10.1200/JCO.2024.42.16_suppl.1629