Follow-up of patients with breast cancer.

Routine, thorough history and physical examinations are the mainstay of follow-up for patients with breast cancer. Yearly mammography of the contralateral breast in all patients is important, as is more frequent radiologic surveys of the ipsilateral breast in patients who had breast-conserving therapy. Frequent chest films and regular bone scans are beneficial only in those patients with advanced disease for improving palliation. In the remaining patients, aggressive attempts at detecting yet asymptomatic metastatic disease through routine bone and liver surveys, sophisticated serum analyses, and serial chest radiographs appears unwarranted. As noted, these measures have not improved disease-free or overall survival compared with that available through treatment of symptomatic metastatic disease.