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Clinical Breast Examination is Important in Surveillance After Mastectomy

  • Paula B Gordon
    Correspondence
    Address for correspondence: Paula B Gordon, MD, FRCPC, FSBI, University of British Columbia, 750 West Broadway, Ste 505, Vancouver, BC V5Z 1H4, Canada.
    Affiliations
    University of British Columbia, Vancouver, British Columbia, Canada
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      To the Editor,
      I read with interest, the paper in press by Tun SM et al: Mode of Detection of Second Events in Routine Surveillance of Early-Stage Breast Cancer Patients.
      • Tun SM
      • Alluri S
      • Rastegar V
      • Visintainer P
      • Mertens W
      • Makaru-Judson G.
      Mode of detection of second events in routine surveillance of early-stage breast cancer patients.
      I applaud their efforts to determine the mode of detection (MOD) of cancer recurrences in 351 patients with early-stage breast cancer over a 5-year period, who had at least 5 years of follow-up, as MOD data is not currently collected in most registries.
      Happily only 10 had recurrences. Of the 8 in-breast tumor recurrences and contralateral primary cancers, 7 were detected by annual mammography. (The MOD of the 8th was not stated in the available abstract.) Both of the 2 chest wall recurrences in postmastectomy patients were detected by clinical breast examination (CBE).
      Yet the authors downplay the relevance of CBE by citing that, “Provider CBE was MOD in only 2/351, 0.6% 95% CI (2.1-0.1%) of patients as chest wall recurrences post-mastectomy.” I argue that the better data point is that 2/10 recurrences were detected by CBE, that is, 20%; Not the 0.6% that led the authors to conclude that CBE had low impact.

      Disclosure

      The authors have stated that they have no conflicts of interest.

      Reference

        • Tun SM
        • Alluri S
        • Rastegar V
        • Visintainer P
        • Mertens W
        • Makaru-Judson G.
        Mode of detection of second events in routine surveillance of early-stage breast cancer patients.
        Clinical Breast Cancer. 2022; (Pre-print Proof Published:June 28DOI)https://doi.org/10.1016/j.clbc.2022.06.003