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>>>Dr. Margileth: One of the most common questions that we receive as medical oncologist is the
very good question, “how do I know if I am disease free at the completion of therapy?”
The quick answer to that is that is that we do not know.
When the number of tumor cells in the body has fallen below a certain level, there is
no tests that we know of that will detect them, so that after the patient has complete
a therapy, all the physical exam may be normal, the laboratory studies may be normal and various
scans may all be normal. We do not know whether that patient has a small number of microscopic
tumor cells left behind that may ultimately recur or whether they are no cells left behind
and the patient is destined to be cured.
There is obviously research looking at that question to try to find ways of determining
microscopic amounts of tumor but at this point, we would appear to be a long way away from
being able to answer that question in that way.
So this why long-term follow-up of breast cancer is important to see whether the patient
does have a recurrence, most recurrences are within the first several years of follow-up,
so that we can follow-up patients more often during the first five years than later but
we do some time see late recurrences, although they can be quite rare. So when the patient
asked that question, the honest answer is we do not know and the only way to know is
long-term follow-up.