Routine marker testing and recurrence... worth it?

[Margerie]

Well, I read the "Up to Date" article. Their license agreement prevents me from posting the article. They do conclude that there is no quality of life benefit from a more intensive surveillance strategy as compared to regular surveillance (physical exams and mammography) alone. BUT the two hallmark studies they quote were both done in 1994:

Impact of follow-up testing on survival and health-related quality of life in breast cancer patients. A multi-center randomized controlled trial. The GIVIO Investigators. JAMA 1994; 271:1587.

Rosselli Del Turco, M, Palli, D, Cariddi, A, et al. Intensive diagnostic follow-up after treatment of primary breast cancer. JAMA 1994; 271:1593.

These were the 2 main studies, there were other smaller studies with dates from 1985 to 2005 (one study).

They do note that there was a study on 9,000 bc patients that demonstrated that elevated tumor markers can predict relapse with a lead time of 5-6 months over clinical symptoms. They debated whether or not the 5-6 months notice was a pro or a con. My feeling is the newest treatments can make use of the earliest detection for prolonged survival and QOL. None of these studies focused on Her2+ patients.