Study Evaluates Methods for Breast Cancer Recurrence Surveillance

Ali Duffens, MD, San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, discusses a study in which investigators assessed the mode of detection for breast cancer recurrence within an integrated health system by assessing the utility and outcomes of current surveillance guidelines recommended by the National Comprehensive Cancer Network.

A cohortof patients from the Kaiser Permanente Northern California were the focus of the study and consisted of 4,431 women diagnosed with stages I-III invasive breast cancer between 2006 and 2013, with follow-up through December 2021.

According to Duffens, they found there to be a high incidence of distant metastatic recurrences indicating the need for better screening methods to detect metastatic disease earlier.

Transcription:

0:09 | My presentation was titled, assessing mode of detection of breast cancer recurrence in invasive breast cancer survivors undergoing surveillance after initial treatment. This was a prospective cohort study, and it utilized data from the PATHWAY study, which is a comprehensive cohort study of women diagnosed with invasive breast cancer within the Kaiser Permanente Northern California Health System.

0:33 | Enrollment for the study was from 2006 to 2013 and participants were followed until December 31, 2021, so for 10 years. Participants are selected from adult women diagnosed with stages I through III invasive breast cancer. Inclusion criteria mandated that participants were over 21 years old, current Kaiser members diagnosed recently, and able to communicate in English, Spanish, Cantonese, or Mandarin.

1:04 | The study included several modalities for detecting breast cancer recurrence, including patient driven symptoms, so recurrences reported by patients based on their symptoms, surveillance mammograms, diagnostic testing, including PET CT, MRI and other advanced imaging techniques, routine clinical breast exams conducted by oncologists and OB GYN, and then an incidental finding.

1:31 | The primary outcomes of the study are focused on assessing the mode of detection of breast cancer recurrence among this cohort of asymptomatic patients who are undergoing surveillance following the initial treatment of invasive breast cancer. And then secondary outcomes involve comparing the demographic clinical tumor and treatment care risk characteristics of Kaiser patients who experienced recurrent breast cancer compared to those who did not. And then the study found that routine survivorship clinical breast exams had a low detection rate for recurrences, with only 6.8% of recurrences being detected this way.