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David V. Schapira, MB, ChB, FRCPC
H. Lee Moffitt Cancer Center and Research Institute University of South Florida College of Medicine Tampa

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.

In Reply.—

In response to Drs Cohen and Somers, we did not suggest that a minimalist policy would not include screening for second primary tumors. We agree that these screening procedures should be done in a routine fashion in patients with cancer.

In response to Dr Liberati et al, we do not argue for a minimalist policy based on opinion and belief. The studies that we cited1-4 are all in agreement that laboratory and radiological testing are the initial modes of discovery in only 15% of cases. Additionally, the study we cited by Zwaveling et al⁵ demonstrated that surveillance of patients with breast cancer did not affect time from diagnosis to recurrence or time from diagnosis to death when compared with patients who were not followed up.

Thus, according to currently available data, these additional laboratory and radiological tests do not significantly facilitate detection of recurrence or prolong survival. . . . [Full Text PDF of this Article]

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