Table 1.

Surveillance and screening for asymptomatic breast cancer survivors

do ...
Primary care visit with history and physical examination• Every 3–6 mo for years 1–3 after treatment; every 6–12 mo for years 4 and 5; then annuallyIII14
• History to focus on symptoms of distant (bone, lung, liver, brain) and local recurrence
• Examination focuses on surgical scar, breasts, chest wall, regional nodes, arms for lymphedema, and common sites of distant spread
• Annual gynecologic examination for patients taking tamoxifen
Breast self-examination• Monthly breast self-examination is recommended in this higher risk groupIII14
Mammography• Annually, starting 1 y after initial mammogram but at least 6 mo after radiation therapy is complete; can perform every 6 mo in select cases; no routine imaging of a reconstructed breast is neededII14
Screen for other cancers• As for average-risk individuals, unless family history suggests otherwiseII15
do not do ...
Breast magnetic resonance imaging• Not recommendedI14,16,17
Other tests
  • Complete blood counts

  • Liver function tests

  • Routine imaging of chest, abdomen, or bone

  • Tumour markers

• Not recommendedI14,18
Cardiac imaging• Not recommended after completion of anthracycline (epirubicin, doxorubicin) or trastuzumab therapy unless there are symptomsIII15
  • * Level I evidence includes at least 1 properly conducted randomized controlled trial, systematic review, or meta-analysis. Level II evidence includes other comparison trials; non-randomized, cohort, case-control, or epidemiologic studies; and preferably more than 1 study. Level III evidence includes expert opinion or consensus statements and influential reports or studies.