Follow-up in Breast Cancer

The chance of breast cancer recurring is especially in the first 2 years. If there is to be a recurrence, research shows that 80% of the recurrence occurs within the first 2 years. For this reason, it is recommended that the patient be monitored every 3 months for the first 2 years. Monitoring is applied in three ways;

Breast Examination
Radiological Examinations

Breast USG: Ultrasound examination of breast tissue is performed every 3 months for the first 2 years, then every 6 months. It is performed to monitor whether there is a recurrence in the breast. If something is detected here, further tests are added.
Whole abdominal USG: Performed every 3 months for the first 2 years, then every 6 months. It is performed to detect possible metastases (especially liver) in the early stages of breast cancer. At the same time, the ovaries and the inside of the abdomen are scanned for early diagnosis of possible metastases. When a suspicious focus is detected, it is investigated with further tests.
Lung X-ray: Used for early diagnosis of lung metastases to breast cancer.
Tomography: Scanning is continued every 6 months for the first 2 years. It is preferred for detecting and monitoring the spread of breast cancer in the body. In these scans, Thorax CT and Whole Abdominal CT are routinely used. Tomography of other areas of the body may also be taken in line with the patient's complaints. If the patient has a headache, brain tomography is performed, and if there is pain in the waist, hip or other bones, bone tomography such as waist and hip is added.
MRI: It is used for diagnostic purposes within the breast tissue, especially when diagnosis cannot be made with other examinations. It seems to be effective in the diagnosis of structures 5 mm and larger. It is also preferred in the detection and follow-up of spreads called metastasis. It is repeated once a month for the first 2 years, then once a year.

Tomography and MRI are important in the follow-up as well as the diagnosis of breast cancer. These two methods are preferred to detail and confirm the diagnosis of suspected areas of breast cancer and its metastases. Since the sensitivities of each organ are different, the physician may request different tests for each patient. In addition, since the PET will be insufficient to read the metastases in the brain, PET examinations are added especially in the initial diagnosis of the disease in the patient where spread is suspected.

PET: Generally used in initial diagnosis. If the patient is not metastatic, PET have no place in routine follow-up. In case of a complaint or a deterioration in the laboratory, the entire product is used for screening purposes in cases where metastatic disease is suspected. Radioactive labeling is the preferred diagnostic method for many types of cancer that may develop in the body, especially in terms of detecting and monitoring their spread.
Bone Scintigraphy: Diagnosis is a method performed to scan the bones if there is only a suspicion of bone metastasis in case of a deterioration in the laboratory conditions in which pain in the waist, knee or other bones is described.
Bone Densitometry: It is a bone density measurement. It is used in the treatment and follow-up of breast cancer. Hormones can cause osteoporosis. Annual bone densitometry is performed to monitor whether patients develop osteoporosis due to medications.

3- Laboratories

Purpose of doing it;

To understand whether breast cancer has recurred.
Screening for other cancers that may occur along with breast cancer.
Screening for risk factors, primarily hormonal, that may make it difficult to monitor breast cancer or increase the risk of recurrence.

Laboratory Examinations

Breast examination is performed by the monitoring surgeon, then repeated every 6 months and possible palpable masses are monitored for both breasts.

Ca+

CRP

CEA

Ca125

Ca19-9

Alfafotoprotein

Akş

SGOT

GGT

Mangnesium

Na+

TSH

Hemogram

B12

Vit D3

Sedim

Ca15-3

İnsulin

SGPT

LDH

K+

Seleyum

Spot

İdrarda İyot