"Frequent metastasis tests after breast cancer treatment, no significant effect on improving survival rates"
Oct 01, 2024
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Professor Moon Hyung-gon of Seoul National University Hospital and Professor Cheon Jong-ho of Seoul Metropolitan City Boramae Hospital announced the results of a retrospective multicenter study on the 30th that analyzed the relationship between the frequency of distant metastasis tests and survival rates based on data from 4130 patients who underwent breast cancer surgery at 11 hospitals in Korea from 2010 to 2011.
Breast cancer is the most common cancer among women worldwide, accounting for 22.2% of all female cancer patients, according to the 2021 National Cancer Registry statistics. Although the mortality rate is relatively low compared to other carcinomas, the prevalence rate is high, so management after primary treatment is very important.
Remote metastasis testing is a test to determine whether cancer has spread to organs or tissues (bones, lungs, liver, etc.) far away from the original site, and imaging methods such as CT, MRI, PET-CT, and bone scans are mainly used. Although international breast cancer practice guidelines do not recommend regular distant metastasis tests for asymptomatic breast cancer patients, many patients are frequently tested in Korea due to concerns about recurrence and expectations that early detection may increase survival rates.
Based on the median of the frequency of distant metastasis tests of all patients, the research team analyzed the survival rate by dividing it into ▲high frequency test group ▲low frequency test group and following it for 9 years and 2 months.
As a result, distant metastasis occurred in 301 patients, 7.3% of all patients, and the high-frequency test group tended to detect metastasis faster than the low-frequency test group. In particular, high frequency tests in bone, lung, and liver metastases were analyzed to be advantageous for early detection. This suggests that frequent testing may contribute to early detection of metastases.
However, the Breast Cancer-Specific Survival (BCSS) analysis showed that the survival rate of the high-frequency test group was lower than that of the low-frequency test group. This is interpreted because the frequency of testing does not directly improve survival, and patients with poor prognosis were tested more often.
Additionally, multivariate analysis and propensity score matching analysis that corrected various clinical factors such as breast cancer stage also confirmed that high frequency tests did not significantly affect survival rates. This study presents important results that frequent imaging tests were useful for early detection of lung and bone metastases, but were not directly associated with improved survival rates.
Professor Hyun-jo Yoon (baby thyroid surgery) at Chonbuk National University Hospital and Chairman of the Survivor Research Institute of the Korean Breast Cancer Society "It is not necessary to perform frequent distant metastasis tests on all breast cancer patients."We need customized follow-up management tailored to the patient's condition. "
Professor Moon Hyung-gon of Seoul National University Hospital said, `This study is significant in that it provides important evidence to help breast cancer patients determine the need for tests in conducting distant metastasis tests after first-line treatment.'
Professor Cheon Jong-ho (surgery) of Seoul Boramae Hospital said, `Since this study is a retrospective analysis of patients treated in 2010, there is a limitation that it does not reflect the advancements of the latest diagnostic technology and treatments"Therefore, large-scale prospective studies reflecting these factors are needed" he added.
The study was carried out as part of the 2022 Korea-centered medical technology optimization research project supported by the Korea Institute of Health and Medical Sciences, and was published in the recent issue of the international journal 『Annals of Surgical Oncology』 published by the American Society of Oncology.
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