Surveillance for Stage II Invasive Ductal Carcinoma

Surveillance Schedule

The American Society of Clinical Oncology recommends history and physical examination every 3-6 months for the first 5 years, then annually thereafter, with annual mammography for patients with stage II invasive ductal carcinoma 1
The American Society of Clinical Oncology suggests that the more frequent interval (every 3 months) should be considered for patients at higher risk of recurrence within this stage II category 1
The American Society of Clinical Oncology recommends against routine cross-sectional imaging (CT, MRI, PET) in asymptomatic patients with stage II invasive ductal carcinoma 1

The American Society of Clinical Oncology recommends focusing on symptoms of recurrence, including new breast masses, bone pain, chest pain, abdominal pain, persistent cough, or neurological symptoms during history-taking for patients with stage II invasive ductal carcinoma 1
The American Society of Clinical Oncology suggests reviewing systems targeting common sites of breast cancer recurrence (bone, lung, liver, brain) during history-taking for patients with stage II invasive ductal carcinoma 1
The American Society of Clinical Oncology recommends breast examination of both the treated breast and contralateral breast during physical examination for patients with stage II invasive ductal carcinoma 1
The American Society of Clinical Oncology suggests examining regional lymph node basins (axillary, supraclavicular, infraclavicular) during physical examination for patients with stage II invasive ductal carcinoma 1
The American Society of Clinical Oncology recommends abdominal examination to assess for hepatomegaly during physical examination for patients with stage II invasive ductal carcinoma 1

The American Society of Clinical Oncology recommends against routine tumor markers (such as CA 15-3, CA 27.29, or CEA) for surveillance in asymptomatic patients with stage II invasive ductal carcinoma 1
The American Society of Clinical Oncology suggests that laboratory studies should only be performed when clinically indicated by symptoms or examination findings for patients with stage II invasive ductal carcinoma 1

Approximately 41-83% of recurrences are detected by patient-reported symptoms, making patient education about warning signs essential for patients with stage II invasive ductal carcinoma 2
Physical examination detects 35-68% of recurrences in patients with stage II invasive ductal carcinoma 2
Most recurrences in breast cancer occur within the first 3 years after treatment, justifying more intensive early surveillance for patients with stage II invasive ductal carcinoma 2
The highest risk period for relapse is within the first 2-4 years for patients with stage II invasive ductal carcinoma 1

The American Society of Clinical Oncology recommends that patients with severe comorbid conditions who are not candidates for surgery or systemic therapy should not undergo surveillance testing for stage II invasive ductal carcinoma 1
The American Society of Clinical Oncology suggests that surveillance intensity should be guided by functional status and ability to tolerate treatment for recurrent disease for patients with stage II invasive ductal carcinoma 1
The American Society of Clinical Oncology recommends obtaining cross-sectional imaging for new or worsening symptoms suggestive of metastatic disease in patients with stage II invasive ductal carcinoma 1
The American Society of Clinical Oncology suggests obtaining cross-sectional imaging for abnormal physical examination findings in patients with stage II invasive ductal carcinoma 1

The American Society of Clinical Oncology recommends against ordering routine PET scans for surveillance outside of clinical trials for patients with stage II invasive ductal carcinoma 1