Breast Cancer Follow Up

Monitoring

Disease progression is characterized by ≥1 of the following factors: Worsening symptoms, worsening signs or new disease on physical examination, declining performance status, unexplained weight loss, increased alkaline phosphatase, aspartate transaminase (AST), alanine transaminase (ALT), bilirubin or serum calcium level, new lesions on imaging exams, increased lesion size on imaging, increasing tumor markers (eg carcinoembryonic antigen, CA 15-3, CA 27.29).  

History taking and physical examination, performance status assessment, weight measurement, liver function test (LFT) and CBC should be done every 1-3 months for patients given endocrine therapy and to be done before the start of each chemotherapy cycle.  

A follow-up CT scan of the chest, abdomen or pelvis is recommended every 2-6 months for patients given endocrine therapy and every 2-4 cycles for patients undergoing chemotherapy. Bone scan every 4-6 cycles is recommended for patients undergoing chemotherapy and every 2-6 months for patients given endocrine therapy. Repeat PET/CT scan and tumor markers may be obtained as clinically indicated.