Follow-up Of Cancer Patients Research Articles

P021 - Long-term follow-up of HER2-positive early breast cancer patients with adjuvant trastuzumab: the real-world result and unmet needs

P021 - Long-term follow-up of HER2-positive early breast cancer patients with adjuvant trastuzumab: the real-world result and unmet needs

PT074 - A prospective randomized trial of paper versus digital PROMS follow-up in prostate cancer patients after radiation therapy: Acceptance of digital follow-up by patients

PT074 - A prospective randomized trial of paper versus digital PROMS follow-up in prostate cancer patients after radiation therapy: Acceptance of digital follow-up by patients

HE4 is superior to CA125 in the detection of recurrent disease in the follow-up of high risk endometrial cancer patients

HE4 is superior to CA125 in the detection of recurrent disease in the follow-up of high risk endometrial cancer patients

Abstract OT2-01-05: A randomized controlled trial comparing post-operative intensive follow-up with standard follow-up in high-risk breast cancer patients (JCOG1204: INSPIRE)

Abstract Background: The standard follow-up after surgery for breast cancer includes periodic interviews, clinical examinations, and mammography, but many institutions are conducting intensive follow-up including periodic computed tomography(CT), magnetic resonance imaging(MRI), and bone scintigraphy in the world, despite the lack of evidence to support this approach. While intensive follow-up may contribute to prolonged survival through earlier diagnosis and treatment of relapse, it has the disadvantages of high effort and costs placed on patients(pts) and healthcare workers, radiation exposure for imaging examinations, and overtreatment owing to false-positive results. Although past two randomized trials could not show significant difference in overall survival (OS), as imaging methods have remarkably improved, leading to the earlier detection of relapse, and medical therapies have remarkably improved in recent years, randomized controlled trials are needed to confirm whether intensive follow-up can really prolong survival sufficiently to offset these disadvantages in high-risk breast cancer pts. Trial design: This study is a multi-institutional two-arm open label randomized controlled phase III trial being conducted with the participation of 42 hospitals belonging to the Breast Cancer Study Group of Japan Clinical Oncology Group. Eligible pts are randomized either to the intensive follow-up group or to the standard follow-up group; the former will undergo physical examination, bone scintigraphy, chest and abdominal CT, brain MRI/CT and frequent tumor markers, whereas the latter will undergo physical examination at the same frequency and tumor markers will be evaluated once a year. Mammography once a year is planned for both groups. This trial has been registered at the UMIN Clinical Trials Registry as UMIN000012429. Eligibility criteria: High-risk breast cancer pts, who are expected to have recurrence rates of over 30% within 5 years after surgery. The main inclusion criteria are as follows: four or more axillary nodal metastases in the estrogen receptor (ER) positive pts without neoadjuvant chemotherapy(NC)., axillary node metastases in ER-negative pts without NC, axillary nodal metastases in ER-positive pts with NC, histologically proven residual invasive cancer in the breast or axilla in ER-negative with NC. Specific Aims: The primary endpoint is OS, and secondary endpoints are disease-free survival, relapse-free survival, distant metastasis–free survival, OS in intrinsic subtypes, actual number of implemented examinations, compliance with pre-specified examinations, and adverse events. Statistical methods: The primary endpoint will require a total of 538 events to be assessed in order to obtain a statistical power of 80% with a one-sided significance level of 0.05. Thus, the planned sample size to compare the two survival curves is set at 1500 pts, assuming an accrual time of 6 years and a follow-up time of 7 years according to the Schoenfeld and Richter's method. Present accrual and target accrual: The trial was activated in November 2013. 773 pts have been enrolled by the end of June 2018. Contact: Principal investigator Takashi Hojo MD tahojo@east.ncc.go.jp Citation Format: Hojo T, Masuda N, Shibata T, Mizutani T, Shien T, Kinoshita T, Iwatani T, Kanbayashi C, Kitagawa D, Tsuneizumi M, Iwata H. A randomized controlled trial comparing post-operative intensive follow-up with standard follow-up in high-risk breast cancer patients (JCOG1204: INSPIRE) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-01-05.

Abstract P1-11-19: E-DomSanté study on the improvement of care in oncology through digital technology

Abstract Background: The effectiveness of remote follow-up of cancer patients through weekly medical questionnaires filled in on their smartphone has been reported in international studies. These studies demonstrated an improvement in quality of life (QoL) and survival of several months. The e-DomSanté study proposes the combined use of innovative technological tools for the improvement of patient care. Patients and methods: This 2-year pilot study was carried out with patients followed-up for metastatic breast cancer who lived far from their treatment center. They were offered, in addition to their usual follow-up, weekly medical questionnaires (10 items) on an interactive tablet and a connected watch that registered their falls, bedtime and their general activity. All this data arrived on a secure portal. In the event of an alert, telemedicine was organized by remote consultation with exchange on a secure platform, in parallel, between the center's carers and the treating physician, nurse, pharmacist or the Territorial Support Unit. The evaluation criteria used included telemedicine and patients' QoL (FACT-B questionnaires) as well as their satisfaction with their care. Results: The average age of the 15 patients included in the study was 65 years (range, 36-82 years) with one third of patients who had never used a computer or tablet. Those patients as well as elderly patients (≥ 75 years old) adapted very well to the technology simply with reinforced education and modification of the ergonomics of tablets and questionnaires. The requests for remote consultation were mainly due to 1) symptoms of deteriorating disease detected in advance, 2) toxicities relating to the treatment making it possible to adapt the therapy quickly, 3) the support oncological care (pain, depression or taken into terminal care at home) and 4) exhausted relatives. The QoL of all patients was stable or even improved despite progression of their metastatic disease in most cases. Practically all patients were satisfied (less fatigue due to less travel, high responsiveness of carers, security and confidence, less stress) with just a few criticisms (stress generated by the technology, no space for comments in the questionnaires and the restrictive nature of wearing the watch). Conclusions: The e-DomSanté study confirms the contribution of digital technology in improving cancer care. This system avoids unnecessary consultations that are tiring for the patient and costly for society (transportation and hospitalization). It also avoids acute admissions through the emergency room. This method leads to an improvement in the QoL of patients and their satisfaction with their care. A second, much larger, multicenter randomized trial assessing patients' survival, QoL of patients and their relatives and medico-economic assessment will commence soon. Citation Format: Quénel-Tueux N, Allam V, Desroches M, Duguey-Cachet O, Fillatreau C, Beaufrère P, Trézéguet V, Cassauba S, Portolan N, Caubet C, Rodrigues J, Saint-Upéry N, Gourgues A, Oukhemanou C, Savino F, Maurel M, Burbaud T, Jacques M, Lamurey D, Buyse P-E, Volpato-Coilier M, Michardière E, Hoppe S. E-DomSanté study on the improvement of care in oncology through digital technology [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-19.

Bladder Cancer Diagnosis and Follow-Up: The Current Status and Possible Role of Extracellular Vesicles.

Diagnostic methods currently used for bladder cancer are cystoscopy and urine cytology. Cystoscopy is an invasive tool and has low sensitivity for carcinoma in situ. Urine cytology is non-invasive, is a low-cost method, and has a high specificity but low sensitivity for low-grade urothelial tumors. Despite the search for urinary biomarkers for the early and non-invasive detection of bladder cancer, no biomarkers are used at the present in daily clinical practice. Extracellular vesicles (EVs) have been recently studied as a promising source of biomarkers because of their role in intercellular communication and tumor progression. In this review, we give an overview of Food and Drug Administration (FDA)-approved urine tests to detect bladder cancer and why their use is not widespread in clinical practice. We also include non-FDA approved urinary biomarkers in this review. We describe the role of EVs in bladder cancer and their possible role as biomarkers for the diagnosis and follow-up of bladder cancer patients. We review recently discovered EV-derived biomarkers for the diagnosis of bladder cancer.

Can We Discharge Dynamically Risk-Stratified Low-Risk (Excellent Response to Treatment) Thyroid Cancer Patients After 5 Years of Follow-Up?

AimsThe 2014 British Thyroid Association thyroid cancer guidelines recommend lifelong follow-up of thyroid cancer patients. This is probably unnecessary, can cause patient anxiety, is time consuming and places significant demand on National Health Service resources. It has been suggested that low-risk differentiated thyroid cancer (DTC) patients could be discharged to primary care once they are 5 years from diagnosis and treatment. The aim of this study was to investigate the potential safety of this practice. Materials and methodsIn total, 756 patients with dynamically risk-stratified (DRS) low-risk/excellent response to treatment DTC treated over 2001–2013 in the Leeds region were followed after diagnostic surgery and the recurrence rate calculated. ResultsThe median follow-up time was nearly 10 years (5–17 years). Radiological recurrence occurred in 13/756 (1.7%) patients and was always preceded by raised thyroglobulin/ thyroglobulin antibody levels. In all 13 patients elevation of thyroglobulin occurred within 5 years of diagnosis. Two additional patients were found to have rising thyroglobulin at almost 9 and 10.5 years from diagnosis, although to date radiological recurrence has not been detected. Assuming these two patients developed recurrence with longer duration of follow-up, then 0.26% (2/756) of patients would not have their recurrence discovered within 5 years of diagnosis. To detect 100% of patients with a putative recurrence in our cohort would require 10.5 years of follow-up. Four patients had transiently raised thyroglobulin, which became undetectable within 2 years (in three patients), without any treatment and radiological recurrence was not discovered. ConclusionDischarge of DRS low-risk DTC patients to primary care after 5 years of secondary care follow-up is reasonable, accepting that late recurrence may occur in a very small minority of individuals (0.26%, ∼1:400). A more cautious approach would be to continue monitoring for 10 years, although the frequency of assessments could be reduced with increasing duration of follow-up.

Re: MicroRNA-371a-3p as Informative Biomarker for the Follow-up of Testicular Germ Cell Cancer Patients.

Re: MicroRNA-371a-3p as Informative Biomarker for the Follow-up of Testicular Germ Cell Cancer Patients.

Follow-Up and Surveillance after Lung Cancer Treatment

The aim of this article is to present the current guideline recommendations for the follow-up and surveillance of lung cancer patients and to outline an evidence-based approach to planing individualised follow-up care.

Quantitative Analysis of HER2 Amplification by Droplet Digital PCR in the Follow-Up of Gastric Cancer Patients Being Treated with Trastuzumab after Surgery

Background Circulating tumor DNA (ctDNA) derived from tumors is a promising biomarker for monitoring tumor status and evaluating therapeutic effects and prognosis. We studied the plasma human epidermal growth factor receptor 2 (HER2) amplification in gastric cancer (GC) patients by droplet digital PCR (ddPCR) during therapy with trastuzumab. Methods A total of 12 patients were recruited after surgery. All patients received FOLFOX chemotherapy combined with trastuzumab as a treatment regimen. During the 12 months of the follow-up period, using elongation factor Tu GTP binding domain containing 2 (EFTUD2) as a reference gene, plasma HER2 to EFTUD2 ratios (the HER2 ratio) were determined for each patient every 2 months by ddPCR. Results The concordance rate of HER2 amplification examined in plasma and formalin-fixed paraffin-embedded (FFPE) samples with ddPCR was 81.4%, with a sensitivity of 76.5% and a specificity of 83.8%. Plasma HER2 ratios were correlated with the primary tumor size (p < 0.01). A significant decrease in the plasma HER2 ratio was found after two months of treatment (p < 0.0001). Nine patients experienced partial response, and three patients had stable disease. Seven patients had progressive disease (PD) during follow-up, and four of them had died. The median progression-free survival (PFS) was 9.8 months. For each patient who developed PD, the plasma HER2 ratio was approximately 2.3-4.1 times higher than the cut-off value at the time of PD, which was the highest during the whole follow-up period. Conclusion Longitudinal monitoring for the plasma HER2 ratio by ddPCR in the clinical courses of GC patients holds great promise for use as an indicator of tumor progression and treatment efficacy.

Comprehensive management guideline for breast cancer follow-up and concomitant diseases

In recent years, with the emphasis on breast cancer screening and the improvement of breast cancer diagnosis and treatment, five-year survival rate and the overall survival time of breast cancer patients have been significantly improved in China. The adverse events caused by patients' age, changes in hormone levels or anti-cancer treatment during follow-up have become new challenges in the management of patients with breast cancer, not only affecting the quality of life, but also impacting disease recurrence and death. The management of patients should not be restricted to the diagnosis and treatment of breast cancer, but to a most comprehensive management. This could improve the therapeutic efficacy of anti-cancer treatment and the quality of life of patients. Based on the current landscape of treatment and follow-up of breast cancer patients in China, the experts committee drafted the "Comprehensive Management Guideline for Breast Cancer Follow-up and Concomitant Diseases" according to the literature and relevant guidelines. This guideline is composed of four parts: path diagram, follow-up management, concomitant diseases and adverse events management. It aims to standardize the long-term follow-up of breast cancer patients, guide clinicians to deal with the concomitant diseases and adverse events, and further improve the prognosis and quality of life of breast cancer patients in China.

Development of a Multi-professional Testicular Cancer Patient Follow-up Clinic – Experience from the Royal Marsden Hospital

Development of a Multi-professional Testicular Cancer Patient Follow-up Clinic – Experience from the Royal Marsden Hospital

EPROs in the follow-up of cancer patients treated with immune checkpoint inhibitors: a retrospective study

PurposePatient-reported outcome (PRO) follow-up has been shown to improve quality of life (QoL) and survival of cancer patients receiving chemotherapy. Kaiku Health application is a web-based electronic PRO (ePRO) tool which is designed for follow-up of cancer patients receiving immune checkpoint inhibitors (ICI). Purpose of the current study is to investigate whether symptoms collected by Kaiku Health ePRO tool on cancer patients receiving immune checkpoint inhibitors (ICI) follows to symptoms reported in clinical trials and whether coupling of specific symptoms does occur.MethodsWe retrospectively collected data on symptom timing and severity, and QoL of patients followed with Kaiku Health IO module in two Finnish cancer centers between 2017 and 2018. Kaiku Health IO module consists of 18 adaptive questions, which assess the presence and severity of symptoms. Patients were requested (via e-mail) to fill online symptom questionnaires with 3–7 day interval and QoL questionnaires (QLQ-C30) with 1–2 month interval.ResultsThe IO module was used to follow 37 patients who had filled in total 559 symptom questionnaires. There was good adherence to ePRO follow-up with a median of 11 questionnaires filled per patient. The reported symptoms and their severity follow closely what has been seen in clinical trials investigating ICIs. Correlation analysis of the symptoms showed the strongest positive correlations between itching and rash; nausea and vomiting, decreased appetite, or stomach pain; cough and shortness of breath.ConclusionsThe results of the current study suggest that real-world symptom data collected through the ePRO application on cancer patients receiving ICI therapy aligns with the data from clinical trials. Correlations between different symptoms occur, which might reflect therapeutic efficiency, side effects, or tumor progression. These correlations should be further investigated with data coupled to clinical outcomes.

Long Term Follow-Up of Male Breast Cancer Patients, Single Center Experience

Long Term Follow-Up of Male Breast Cancer Patients, Single Center Experience

Prospective Validation of an mRNA-based Urine Test for Surveillance of Patients with Bladder Cancer

BackgroundA fast, noninvasive test with high sensitivity (SN) and a negative predictive value (NPV), which is able to detect recurrences in bladder cancer (BC) patients, is needed. A newly developed urine assay, Xpert Bladder Cancer Monitor (Xpert), measures five mRNA targets (ABL1, CRH, IGF2, UPK1B, and ANXA10) that are frequently overexpressed in BC. ObjectiveTo validate Xpert characteristics in patients previously diagnosed with non-muscle-invasive BC. Design, setting, and participantsVoided precystoscopy urine samples were prospectively collected at 22 sites. Xpert, cytology, and UroVysion were performed. If cystoscopy was suspicious for BC, a histologic examination was performed. Additionally, technical validation was performed and specificity was determined in patients without a history or clinical evidence of BC. Outcome measurements and statistical analysisTest characteristics were calculated based on cystoscopy and histology results, and compared between Xpert, cytology, and UroVysion. Results and limitationsOf the eligible patients, 239 with a history of BC had results for all assays. The mean age was 71 yr; 190 patients were male, 53 never smoked, and 64% had previous intravesical immunotherapy (35%) or chemotherapy (29%). Forty-three cases of recurrences occurred. Xpert had overall SN of 74% (95% confidence interval [CI]: 60–85) and 83% (95% CI: 64–93) for high-grade (HG) tumors. The NPV was 93% (95% CI: 89–96) overall and 98% (95% CI: 94–99) for HG tumors. Specificity was 80% (95% CI: 73–85). Xpert SN and NPV were superior to those of cytology and UroVysion. Specificity in non-BC individuals (n=508) was 95% (95% CI: 93–97). ConclusionsXpert has an improved NPV compared with UroVysion and cytology in patients under follow-up for BC. It represents a promising tool for excluding BC in these patients, reducing the need for cystoscopy. Patient summaryXpert is an easy-to-perform urine test with good performance compared with standard urine tests. It should help optimize the follow-up of recurrent bladder cancer patients.

Importance of Colposcopy Impression in the Early Diagnosis of Posthysterectomy Vaginal Cancer.

The aim of the study was to investigate the value of cytology, high-risk human papillomavirus (hrHPV) status and colposcopy in the early diagnosis of vaginal cancer after hysterectomy. A retrospective study was performed in the Obstetrics and Gynecology Hospital of Fudan University. Posthysterectomy patients who were diagnosed with vaginal high-grade intraepithelial lesion (HSIL) by colposcopy-directed biopsy with colposcopy impression of extensive HSIL or suspicion of cancer and underwent upper or total vaginectomy from January 2009 to December 2017 were included. Eighty-six posthysterectomy vaginal HSIL patients were included. Available abnormal cytology and positive hrHPV were observed in 90.7% (49/54) and 96.2% (51/53) of the patients, respectively. A total of 18.6% (16/86) of the patients were diagnosed with squamous cell cancer by vaginectomy, and the average interval between hysterectomy and vaginectomy was 3.5 years. Among them, 62.5% (10/16) cancers occurred after hysterectomy for cervical cancer, 31.2% (5/16) after hysterectomy for cervical precancer, and 6.3% (1/16) after hysterectomy for myoma. An indication for hysterectomy (cervical cancer vs HSIL, odds ratio = 7.2, 95% CI = 1.9-28.0, p = .004) and colposcopy impression of vaginal cancer (vaginal cancer vs HSIL, odds ratio = 5.9, 95% CI = 1.3-26.8, p = .021) were high-risk factors of cancer confirmed by vaginectomy in colposcopy-directed biopsy vaginal intraepithelial neoplasia 2/3 posthysterectomy in multiple logistic regression analysis. Colposcopy is pivotal in the evaluation of abnormal cytology/hrHPV tests in follow-up of cervical cancer patients after hysterectomy and decision-making for vaginectomy in detecting early cancer.

Risk factors for development of new skin neoplasms in patients with past history of skin cancer: A survival analysis

We conducted a retrospective study aiming to assess the risk, and associated risk factors, of developing subsequent skin cancers after having a first diagnosis of skin cancer. We included all patients with biopsy-proven skin cancer attending a dermatology clinic between July 2007 and July 2017. We assessed the frequency of new skin cancers, as well as potential demographic and clinical factors significantly associated with occurrence of such neoplasms, that were identified by means of a survival analysis. We analyzed 969 patients with a total of 1584 skin neoplasms (1122 basal cell carcinomas (BCC), 310 squamous cell carcinomas (SCC), 143 melanomas and 9 other neoplasms). 165 patients (17.0%) developed subsequent skin neoplasms. Factors identified in multivariable models to be significantly associated with development of new skin cancers included older age (adjusted HR = 1.04 per year; 95%CI = 1.02–1.05; p < 0.001), and presence of synchronous neoplasms (adjusted HR = 2.25; 95%CI = 1.61–3.14; p < 0.001). Having a history of a BCC was significantly associated with development of new BCC (adjusted HR = 1.63; 95%CI = 1.05–2.54; p = 0.030), while having a previous SCC was associated with occurrence of subsequent SCC (adjusted HR = 3.60; 95%CI = 1.93–6.72; p < 0.001). These findings point to the importance of careful follow-up (e.g., skin self-examination and full body examination) of skin cancer patients.

App-Based PRO Monitoring in Geriatric Patients Undergoing Radiation Therapy – An Initial Analysis of the Prospective TeleGraPH Trial

Recent randomized trials indicated that electronic assessment of PRO may significantly improve overall survival of patients with metastatic cancers. Although this is a major advancement in palliative cancer care, there were concerns that only young(er) patients with access to mobile devices may benefit from such digital cancer care. We therefore initiated TeleGraPH (Telemonitoring of Geriatric Cancer Patients Using Handheld Devices), a prospective trial assessing the compliance of elderly cancer patients to use handheld devices for symptom and QOL reporting during/after radiotherapy. TeleGraPH is a prospective feasibility study on an App-based symptom and QOL follow-up (CareOnlineTM, humediQ GmbH, Grünwald) in geriatric cancer patients. Inclusion Criteria were age>60, KPS ≥ 70 and a histologically confirmed primary tumor. Primary outcome is compliance (defined as number of questionnaires answered per time frame, time frame: 0-3 months after enrollment), secondary outcome is HRQL (EORTC-QLQ30). Additional items were the subjective perception of the health status (SPHS) as well as the body weight. We here report data from an interim analysis on compliance and an (exploratory) comparative analysis between curative and palliative patients. The trial is registered with ClinicalTrials.gov, number NCT03196050. A total of 48 patients were included in this interim analysis. 18 patients (38%) were excluded due to personal or study- related issues after enrollment. The median follow-up was 3.5 months (0.4-13.9 months). The most frequent primary disease was prostate cancer (37%), followed by breast cancer (10%), small-cell-lung-cancer (10%) and glioblastoma (10%). The mean compliance after 15 days was 73% decreasing to 55% after 90 days. There were no significant differences with regard to compliance between the curative and palliative groups. However, the palliative group showed a decrease in weight and little to no improvements in SPHS whereas the weight was stable and the SPHS improved in the curative group. This trial established important benchmarks for future digital care of geriatric cancer patients. Roughly 60% of all geriatric cancer patients participate in App-based follow-up during/after radiotherapy, ¾ of those respond within the first 2 weeks and ½ will use this follow-up technology for more than three months. Funded by the Federal Ministry of Economic Affairs of Germany, the H.W. & J. Hector Foundation and humediQ GmbH.

Accelerated Partial Breast Irradiation Outcomes from a Tertiary Referral Community Hospital: Utilizing the Guidelines

Adjuvant radiation therapy using accelerated partial breast irradiation (APBI) has been shown to improve local control when delivered during breast conservation therapy to appropriately selected patients. There are a variety of consensus guidelines available to guide patient selection, including ASTRO 2009 and 2016 guidelines, as well as those from the American Society of Breast Surgeons (ASBS), and the American Brachytherapy Society (ABS). Our aim was to analyze patients treated with APBI at our institution to evaluate outcomes and determine the guidelines that identified patients at high risk for failure without restricting ABPI access to appropriate patients. Following institutional review board approval, we conducted a retrospective review of 260 consecutive patients (171 invasive ductal carcinomas, 89 DCIS) treated with APBI at our institution. From January 2006 to December 2010, a balloon device was used (n=86), and from January 2011 to February 2016, patients were treated with a multicatheter device (n=174). A database was created with patient, tumor, and treatment characteristics. Median age at treatment was 64 (range 46 to 89). Median follow-up was 5.98 years (range 0.2 to 11.45 years). The recurrence rate was 4.23% (n=11), with 7 recurrences in the ipsilateral breast, 2 failures in the ipsilateral axillary nodes, and 2 distant failures. The median time to failure was 3.5 years, with a range of 0.75 to 7.1 years. 54.5% of recurrences were in patients with DCIS (n=6), and 83% of those recurred as DCIS (n=5) while n=1 returned as an invasive ductal carcinoma. The overall mastectomy rate was 2.3% (n=6). Eight deaths occurred, and zero were attributed to breast cancer. 96.5% of patients treated are alive without evidence of disease. Twelve patients experienced fat necrosis on mammography, and six patients had biopsies for this reason. Six patients (2.3%) experienced a symptomatic seroma, and four resolved with a single aspiration. By ASTRO 2009 criteria, 39% were suitable, 54% were cautionary, and 7% were unsuitable. 18% of failures (n=2) were suitable per ASTRO 2009 guidelines, while 55% (n=6) were in the cautionary group. By ASTRO 2016 criteria, 67% were suitable, 31% were cautionary, and 2% were unsuitable. 45% (n=5) of patients who experienced recurrence were in the suitable group per ASTRO 2016 guidelines, while 55% were in the cautionary group (n=6). By ASBS 2008 criteria, 98% were suitable, and only one failure was found to be unsuitable by this grouping. By ABS 2013 guidelines, 96% were suitable, including nine patients who experienced recurrence. No suitability group correlated with recurrence or survival. Long-term follow-up of early stage breast cancer patients treated with APBI demonstrated excellent local control. Low rates of salvage mastectomy, fat necrosis, and symptomatic seromas were observed. Classifying patients according to ASTRO 2009 and 2016 suitability groups, as well as those of ASBS and ABS did not correlate with recurrence risk.

32. Evaluation of the Efficacy of MRI Follow-up of Breast Cancer Patients

32. Evaluation of the Efficacy of MRI Follow-up of Breast Cancer Patients