There are 2 schools of thoughts on surveillance of breast cancer recurrence.
One is the symptom-sign-directed surveillance approach. The other is screening diagnostic-procedure-directed surveillance approach.
Symptom-sign-directed surveillance approach is synonymous with clinical surveillance of breast cancer recurrence.
Here the physician asks patients for presence of any symptoms (how they feel / what they have noticed in their body) that may be suggestive of recurrence, local, regional and distant.
Here the physician also does a physical examination (clinical examination) to check for any signs of recurrence, local, regional and distant.
What are the areas in the body that a physician usually does a physical examination to check for local and regional recurrence?
- Chest area – operated areas, residual breasts after subtotal mastectomy, chest wall after total mastectomy, and intact breast (no previous operation) – to check for local recurrence and new cancer on the intact breast
- Axillary areas to check for possible lymph node metastasis
- Supraclavicular areas to check for possible lymph node metastasis
- Right subcostal area to check for possible hepatic metastasis
Above constitute the areas of focused physical examination for possible local and regional breast cancer recurrence.