1. Paper of The Week
Follow-up may not be beneficial after treatment of grade 1 breast cancer M. Kontos, D. Allen, D. T. Trafalis, G. Jones, H. Garmo, L. Holmberg, H. Hamed Published Online: Jul

2. Background
Routine clinical and/or mammographic follow-up is important for the early detection of locoregional recurrence (LRR)
The study investigated whether the risk of recurrence after treatment for grade 1 breast cancer is sufficiently low to justify the safe discharge of patients after completion of active treatment
The rate of LRR and contralateral breast cancer (CBC) as the first event during follow-up cancer was evaluated for the different tumour grades

3. Metohods
1143 women who had surgery for breast cancer were followed at the Guy’s Hospital Breast Unit between 1990 and 1997
Histological tumour grade was assigned according to the Bloom–Richardson system for breast cancer
Rate of locoregional recurrence or contralateral breast cancer was determined

4. Results
The 10-year cumulative risk of LRR/CBC by grade for Beast-Conserving Treatment & Modified Radical Mastectomy combined was 0·03, 0·12 and 0·16 for grade 1, 2 and 3 cancer respectively
The 10-yr cumulative risk of LRR/CBC for BCT group was 0.05, 0.14 & 0.16 for Grade 1,2 &3 respectively ( median follow-up period 9.6 yrs)
- (P = 0·001)
MRM ( median follow-up period 8.3 yrs)
- 0, 0.09 & 0.16 for grade 1, 2 & 3 respectively
- (P = 0.002)

5. Conclusion
In this study, women with a grade 1 tumour had a risk of LRR or CBC of 285 (95 % c.i. 93 to 670) per person-years
For the year 2004, Cancer Research UK calculated that the risk of breast cancer in the general population is 269 to 358 per person-years