ABSTRACT
Introduction: Since the outbreak of the COVID-19 pandemic, the paradigm has evolved such that virtual breast cancer clinics and surveillance has dominated patient follow-up. Breast cancer patients are routinely followed up for years in surgical, medical oncology and radiation oncology clinics. However, controversies surround follow-up, and its value is uncertain. The aim of this study was to assess whether breast cancer recurrences presenting at our breast unit were detected clinically or radiologically and proportion of the recurrences detected during routine physical exam. Methods: An observational cohort study of retrospective design was performed evaluating patients suffering breast cancer recurrence (locoregional and/or distant) between 2016 and 2020. Electronic hospital records were reviewed to update patient data. Basic descriptive statistics (Chi-square, Fisher's Exact tests) were performed using SPSS version 26.0. Results: In total, 181 patients presented to our unit with breast cancer recurrence during the period of this study. Overall, 88 recurrences were detected clinically and 93 were detected using radiology (48.6% and 51.4%). Interestingly, 77 recurrences were detected by the patient themselves (42%) and only 11 recurrences were detected by physical examination on scheduled appointments (6%). These eleven patients had asymptomatic recurrences identified by clinical exam, which could have been identified by surveillance imaging. Conclusion: Breast cancer recurrences are as likely to be detected clinically as using radiology. Keeping the substantially low cancer detection rate of asymptomatic recurrences, review of data in post covid period requires appropriate utilization of resources for breast cancer follow-up. Long term routine hospital follow-up appears to be inefficient in detecting recurrence.