This leads to the necessity to focus on breast cancer follow-up procedures for the high relevance they have for both patients and professional Vorinostat cost personnel [6]. The primary aim of routine post-operative surveillance after early stage breast cancer

surgery, referred to as ‘follow-up’, is to enhance survival, psychosocial and physical well-being of patients. The effectiveness of different breast cancer follow-up procedures for early detection of metastatic disease is an old issue, starting in the 1980s [7–10]. In the 1990s, evidences from phase III randomized trials (RCTs) demonstrated that intensive follow-up procedures do not improve outcome or quality of life when compared to patients’ Tucidinostat price educations about symptoms referral and regular physical VS-4718 chemical structure examinations [11–18]. Nowadays, there is a general agreement on the utility of yearly mammography for detecting local recurrences and/or second primary cancers while intensive follow-up practices by imaging techniques (i.e. chest radiograph, bone scan and liver sonography) are not recommended by current international guidelines [19, 20]. Nevertheless, the appropriateness of screening tests to be used as well as the frequency of follow-up procedures and the optimal follow-up duration

are still object of debate [21–24], which reflects in the wide use of intensive surveillance and in the long-term follow-up period in everyday clinical practice [6, 25–28]. Based on these premises, we conducted a systematic review of the surveillance procedures utilized in phase III RCTs of adjuvant treatments in early stage breast cancer in order to asses if a similar variance exists in the scientific world. Methods Literature mafosfamide search and eligibility criteria We searched PubMed (PubMed, available at URL: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed) from January 1, 2002

to December 31, 2012 for phase III RCTs of early breast cancer medical adjuvant therapies with disease free survival (DFS) as primary endpoint of the study [29]. We selected only full text publications (not abstracts), written in English-language. Trials on neoadjuvant therapies, neoadjuvant followed by adjuvant therapies, adjuvant bisphosphonates alone, non medical treatments, radiation therapies, adjuvant chemotherapy for loco-regional relapses and non-phase III trials were excluded. When multiple publications of the same RCT were identified, the first publication was selected. We used as keywords: breast cancer adjuvant therapy, clinical trial, phase III, phase 3 and randomized. Data extraction Information extracted from each trial included: date of beginning of patients enrollment, geographic location, number of participating countries, sponsorship by pharmaceutical companies, number of participating centers, number of enrolled patients, follow-up description (modalities, frequency and duration).