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Relapse pattern and follow-up of breast cancer.

The aim of this study was to evaluate the first relapse pattern in relation to the known prognostic factors in a clinical sample of 1486 breast cancer patients. The higher the stage or grade, the earlier the relapses appeared. The percentage of bone and lung metastases was significantly higher in stage III (15% and 12%, respectively) than in stage I (6% each). Cancers of the opposite breast were more common in grade I than in higher grades. Distant metastases were more common in grade III than in grade I, the difference being highly significant. The recurrence rate was significantly higher in patients under 45 years of age (p less than 0.01) with no differences in the distribution of relapses into sites between the age groups. However, carcinomas of the opposite breast were significantly more common in premenopausal than in postmenopausal patients. Liver metastases, more common with histologically aggressive carcinomas, appeared earlier than other relapses, 92% being found within 5 years. Carcinomas of the opposite breast developed slowly. At least 90% were, in fact, primary tumours. Brain metastases, too, developed more slowly than other relapses. An individual follow-up program based on prognostic factors is presented.