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Martin H. Cohen, MD; Robert G. Somers, MD
Albert Einstein Medical Center Philadelphia, Pa

JAMA. 1991;265(20):2668-2669.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor. —

The appropriateness of minimal or extensive surveillance of patients treated for stages I and II breast cancer recurrence was debated in a recent issue of THE JOURNAL.^1,2 Both points of view were well presented so that physicians have sufficient information to make judgments on this issue.

Unfortunately, breast cancer recurrence may be only the second most important worry of these women. Risk of dying of a nonmammary, second primary neoplasm may exceed, in some subgroups, the risk of dying of breast cancer.³ Everyone agrees that yearly mammography is important to detect local recurrences and new breast primary tumors.^1,2 Considered less often are planned efforts to detect endometrial, cervical, ovarian, colorectal, gastric, oral, and thyroid malignant neoplasms. Each of these neoplasms occurs with greater-than-expected frequency (relative risk, approximately 1.3 to 2.0) in patients with breast cancer.^4-6 The frequency of development of nonmammary . . . [Full Text PDF of this Article]

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