285P Survivorship care plans and recurrence detection in breast cancer patients

Care for people diagnosed with breast cancer (BC) does not end when active treatment has finished, but continues to detect early recurrences and manage side effects. No randomized data exist to support any individual follow-up (FU) protocol. We retrospectively review the Modena Cancer Center survivorship program and its correlation to survival outcomes. A retrospective review of all BC FU visits performed between 2016 and 2023 was done. Descriptive statistical analyses were used to correlate disease characteristics, type of recurrence and mode of relapse with overall survival (OS), estimated by log-rank test and Kaplan-Meier curves. All analyses were performed using R version 4.3.2 (The R Foundation for Statistical Computing, 2023). From June 2016 to June 2023, 20.650 FU visits were done, detecting 256 relapses (1, 2%): 173 distant relapses (67.6%) and 83 loco-regional ones (32.4%). As expected, patients relapsed during the FU period have worse OS compared with those relapsed at the end of the FU program (mOS: 5.6 years vs 8.9 years, respectively; p = 0.001). In particular, tumor markers and/or imaging tests (except for annual mammography), performed routinely, did not improve OS in BC patients (p 0.446 and p 0.792, respectively). Even the frequency of in-person visits (4 vs 6 months) did not improve OS, independently of BC subtypes and clinical stage at diagnosis (p 0.219). Overall, relapse detection due to clinical signs/symptoms, PS ECOG 1-3 and metastatic visceral sites were negative independent prognosticators for survival in multivariate analysis. BC FU visits rarely detected recurrence. An intensive survivorship care plan with tumor markers and/or routine imaging tests did not improve OS. Considering the progressive increasing of BC survivors, the survivorship care program should be redefined. Due to the retrospective and mono-institutional nature of this study, data from prospective clinical trials are needed.