With more than 2 million breast cancer survivors in the United States, breast cancer has a higher cost than other prevalent cancers, with the greatest proportion of the cost related to follow-up care after active treatment.

For patients with breast cancer who have been treated with curative intent, there is no evidence-based data showing that routine measurement of serum tumor markers, CT, or bone scans provide earlier detection of recurrence, or survival benefit, in asymptomatic patients.

Similarly, there are no data to support routine PET scans to assess for metastatic disease in an asymptomatic patient.

The Choosing Wisely campaign has specifically advocated that routine blood tests and imaging with CT, bone or PET scans not be performed routinely in patients who present with early-stage disease and who are treated with curative intent.

Both the American Society of Clinical Oncology and the National Comprehensive Cancer Network recommend annual mammography for all women treated with breast-conservation therapy.

Referecnes:

Khatcheressian JL, Wolff AC, Smith TJ, et al. American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting.

J Clin Oncol. 2006;24:5091-5097. Lewis JL, Tartter PI. The value of mammography within 1 year of conservative surgery for breast cancer. Ann Surg Oncol. 2012;19:3218-3222.

Locker GY, Hamilton S, Harris J, et al. ASCO 2006 update of recommendations for the use of tumor markers in gastrointestinal cancer. J Clin Oncol. 2006;24:5313-5327.

Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, Brown ML. Projections of the cost of cancer care in the United States: 2010-2020. J Natl Cancer Inst. 2011;103:117-128.

National Comprehensive Cancer Network NCCN Clinical Practice Guidelines in Oncology. Breast Cancer. Available at http://www.nccn.org.

American Society of Clinical Oncology. Ten Things Physicians and Patients Should Question. Released April 4, 2012 (1-5) and October 29, 2013 (6-10).