Long-term follow-up after breast conservation: the Edinburgh experience

The value of long-term follow-up of patients treated by breast-conserving therapy is uncertain. An audit was carried out of 341 such patients treated between 1986 and 1990. The follow-up schedule was 3- to 4-monthly for 3 years then 6-monthly thereafter with annual mammography. Relapse occured in 75 patients. The site of first relapse was local in 24, regional in 12, contralateral breast in 4 and distant in 35. The detection rate at routine visits was 0.6% whereas it was 21.5% at interval visits. The detection rate of recurrent cancers on mammography in asymptomatic patients was 0.6%. Ninety-four per cent of patients with distant disease presented with symptoms. The low detection rate for relapse at routine visits and the higher yield among symptomatic patients at interval visits suggests that annual mammography with prompt assessment of symptomatic patients would make better use of clinic resources.