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According to results recently presented at the 45th annual meeting of the American Society for Therapeutic Radiation and Oncology, the combination of mammography and physical examination is important in detecting cancer recurrences in the same breast, as well as cancers in the opposite breast in women diagnosed with stages I-II breast cancer.

Stages I and II breast cancers are considered early breast cancers and have a high rate of a cure following standard treatment regimens. Stage I breast cancer refers to cancer that is less than 2 cm and has not spread to axillary (under the arm) lymph nodes or other areas of the body. Stage II breast cancer refers to cancer that is less than 5 cm and has spread to axillary lymph nodes, or is greater than 2 cm and has not spread to axillary lymph nodes. Standard treatment for stages I-II breast cancer is typically breast conservation treatment (removal of the cancer from the breast), followed by radiation with or without chemotherapy. Following treatment, however, some women still experience a cancer recurrence in the same breast, or another cancer in the other breast. It is important to detect and treat these cancers as early as possible, to ensure optimal chances of a cure.

Researchers from the University of Pennsylvania recently evaluated data from 1,379 patients who had been diagnosed with stages I or II breast cancer between 1977 and 1995. These patients had been treated with breast conservation therapy and followed with physical examination of the breast as well as annual mammography of both breasts. The rate of recurrence within the same breast occurred in 125 patients and the rate of cancer in the opposite breast occurred in 71 patients. Recurrences within the same breast were detected by mammography only in 38% of cases, by physical exam only in 37%, and by both mammography and physical exam in 25% of cases. Breast cancer occurring in the opposite breast was detected in 53% of patients with mammography only, in 23% by physical exam only, and in 24% by both mammography and physical exam. Approximately half of the patients with a recurrence in the same breast or a diagnosis of cancer in the opposite breast had this occur within 5 years of the initial diagnosis, and half had this occur later than 5 years from initial diagnosis.

The researchers concluded that these results indicate that both mammography and physical examination of both breasts are important in detecting cancer recurrences within the same breast, or cancer in the opposite breast, in patients initially diagnosed with stages I-II breast cancer. Furthermore, it is important that both of these detection methods are approached as long-term screening procedures, as approximately half of local cancer recurrences and cancers occurring in the opposite breast were detected at 5 years or longer following initial diagnosis. Patients who have been diagnosed with stages I or II breast cancer should discuss annual mammography an physical examination schedules with their physician.

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Reference: Chen C, Harris E, Orel S, Solin L. The role of mammography and physical examination in detecting recurrent tumor an contralateral breast cancer for patients with stage I-II breast cancer treated with breast conservation treatment. Proceedings from the 45th annual meeting of the American Society for Therapeutic Radiation and Oncology. October 2003. Abstract #13. S131.

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