QUALITY-OF-LIFE ISSUES

Figure 36-69 A 40-year-old woman with diagnosed stage III breast carcinoma had abnormal liver function tests. Intravenous contrast-enhanced computed tomography image of the liver shows two hypodense lesions (arrows) from metastatic breast carcinoma.


One large randomized control study investigated quality of life issues related to surveillance for metastatic disease in breast cancer patients.210 The results suggested that type of follow-up (i. e., intensive surveillance vs. routine clinical management) does not affect various dimensions of health-related quality of life. These dimensions include overall health and quality-of-life perception, emotional well-being, body image, social functioning, symptoms, and satisfaction with care. These parameters were almost identical between intensive and clinical-only surveillance groups. No comparison differences in any of the dimensions of quality-of-life issues were statistically significant between the two groups. Nonetheless, more than 70% of the breast cancer subjects said they wanted to be seen frequently by a physician and undergo diagnostic tests even if they were free of symptoms. This preference for intensive surveillance was not affected by whether the patient had been assigned to the intensive or minimalist follow-up regimen. Education of both physicians and patients seems to be an issue of extreme importance in order to provide cost-effective follow-up management of patients with breast cancer.

Figure 36-70 A 53-year-old woman with stage III breast carcinoma had abnormal liver function tests. A, Precontrast computed tomography (CT) scan of the liver shows inhomogeneous hypodense zones (arrows) caused by metastatic breast carcinoma. B, Intravenous contrast-enhanced CT scan of same patient. The vascular metastases were masked by the contrast agent.


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