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Regular testing for metastases?

Page last modified on: September 17, 2008
Question from Hope: How do you know if you have a recurrence? I know I will be getting mammograms, but that won't show if it has metastasized somewhere else in my body. Should I be getting other tests like scans on a regular basis?
Answers —Eric Winer, M.D.: Generally, most of us don't recommend that women have routine scans after a breast cancer diagnosis and after they have completed treatment. Again, it becomes very important to let your doctor know if you have any unusual symptoms and, if so, lots of times, that is generally when additional tests would be obtained. You're not alone in the sense that it can be very unnerving not knowing for sure whether you're going to remain cancer-free, and this is, unfortunately, something that many woman who've had breast cancer simply have to learn to live with.
Musa Mayer, counselor: As it happens, I have so much to say about this that I've written a book called After Breast Cancer—Answers to the Questions You're Afraid To Ask. The reason I wrote this book is that I myself have had the experience for many years, as a 14-year survivor, of having symptoms that frightened me and wondering if I should have more tests or scans to find a recurrence at the earliest possible moment. So when I read the research that showed quite conclusively that there is no advantage to finding metastatic breast cancer before there are physical symptoms, I was shocked. I thought, "But what about early detection?" It turns out that early detection is only true for primary breast cancer, not for metastatic disease.

There is good research showing that having bone scans, tumor markers, and other tests done in the absence of symptoms only lets you know a little earlier that you have a recurrence. This is a really shocking concept for most women after they've finished their treatment for breast cancer. It's hard to get your mind around it. I found, after a while, that knowing this allowed me to let go of some of my vigilance—of some of my anxiety—so that I could trust my body to let me know if there was a problem.

On Wednesday, September 17, 2003, our Ask-the-Expert Online Conference was called Metastatic Breast Cancer. Musa Mayer, Eric P. Winer, M.D., and Marisa Weiss, M.D. answered your questions about treatment and quality of life issues related to advanced (metastatic) breast cancer.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Copyright 2008. All rights reserved.

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Meet the Experts

Musa Mayer is a trained counselor with a specialty in women's issues, a patient advocate for the National Cancer Institute and has written a memoir of her own experiences with breast cancer.

Eric Winer, M.D.Eric Winer, M.D. is director of the breast oncology center at Dana-Farber Cancer Institute's Gillette Centers for Women's Cancers and associate professor of medicine at Harvard Medical School.

Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.

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