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Alessandro Liberati, MD; Roldano Fossati, MD
on behalf of Gruppo Interdisciplinare Valutazione Interventi Oncologia Mario Negri Institute Milan, Italy

Stefano Ciatto, MD; Marco Rosselli del Turco, MD
on behalf of Coordinating Center National Research Council Project Florence,Italy

JAMA. 1991;265(20):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.—

Drs Schapira and Urban¹ and Dr Wertheimer² discuss the worth of a minimal surveillance policy in patients with early-stage breast cancer. In both articles, the argument in favor or against minimalist follow-up is based on each authors opinions and beliefs rather than on scientific evidence; in fact, no experimental data (ie, results from randomized clinical trials) are yet available. In 1985 in Italy, the controversy over intensive vs minimal follow-up was rampant. The impossibility of reaching a consensus led to setting up a randomized clinical trial. Two cooperative groups designed a trial independently but with the explicit intent of prospectively pooling their results, comparing an intensive vs a minimalist approach (Table). Overall, 43 Italian hospitals joined the two projects.^3-5 From 1985 to 1987, the two trials accrued 1250 and 1450 patients, respectively, and the median follow-up time is now 5 and 3.5 years. Both . . . [Full Text PDF of this Article]

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