Abstract P5-04-04: Does reducing the frequency of regularly scheduled physical examinations affect recurrence detection in patients with early breast cancer?
Notice bibliographique
Résumé
Abstract Purpose: Follow-up care of patients with early breast cancer (EBC) usually includes routinely scheduled physical examinations. While ASCO guidelines recommend a physical exam every three to six months for the first three years, there is little evidence to support this schedule. Health care systems continue to be challenged to meet the future growth in demand from increasing numbers of diagnosed patients and long-term survivors, scarcity of health care workers, and the need to control health care costs. Despite recognition that new follow-up models are needed, there continues to be no generally accepted well follow-up strategy. We evaluated recurrence detection patterns of patients transferred into a single centre survivorship program that follows ASCO recommendations. Methods: Consecutive patients with EBC referred to the Wellness Beyond Cancer Program (WBCP) between February 1, 2013, and January 1, 2019, who had breast cancer recurrence, were reviewed. Descriptive analyses were used to present patients and disease characteristics stratified by type of recurrence and mode of cancer detection. Results: Of 206 recurrences, 135 were distant recurrences (65.5%), 41 were ipsilateral breast recurrences (19.9%), and 30 were contralateral new breast cancers (14.6%). Patient reported symptoms lead to the detection of the majority of distant recurrences (125/135, 92.6%). The most common symptoms of recurrence were bone pain (24.8%), dyspnea/cough (13.1%), abdominal pain (10.7%). Ipsilateral breast recurrences were both quite frequently detected by patients (22/41, 53.7) and by routine mammographic surveillance (17/21, 41.5%). Contralateral breast cancers were primarily detected by imaging 83.3% (25/30). Only 2/206 (1.14%) recurrences/new primaries were detected by a healthcare provider at routinely scheduled follow-up visits. There was a statistical difference in recurrence detection between image detected vs. self-detected in the following factors: grade 3 (26.5% vs 51%, p < 0.007), triple negative breast cancer (3.9% vs. 15.1%, p=0.03), and HER2 disease (18.4% vs. 9.8%, p= 0.04). Conclusions: Despite regularly scheduled in-person follow-up visits following ASCO guidelines, healthcare providers rarely detect recurrences. Our data suggests that 30,000 – 35, 000 follow-up visits were required for the healthcare providers to detect these 2 recurrences. This leads to further need for proper survivorship programs with patient and provider education, and concentration on targeted surveillance. Provided patients attend regular screening tests, our data points to less frequent in-person follow-up being associated with non-inferior breast cancer-related outcomes. Future prospective studies are required looking at different models of follow-up. SABCS Abstract Table Citation Format: Ana-Alicia Beltran-Bless, Bader I. Alshamsan, Mashari Alzahrani, John Hilton, Kelly-Anne Baines, Vicky Samuel, Gregory R. Pond, Lisa Vandermeer, Mark Clemons, Gail Larocque. Does reducing the frequency of regularly scheduled physical examinations affect recurrence detection in patients with early breast cancer? [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-04-04.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».