To the Editor.
—The studies published recently by the GIVIO Investigators1 and by Rosselli Del Turco et al2 are timely and well intended. However, the conclusions drawn by the investigators might be misleading.The conclusion reached by the GIVIO group is that the health-related quality of life of breast cancer patients was the same whether follow-up examinations were performed with or without imaging procedures and laboratory tests. This conclusion was based on responses to questionnaires; 68% (901 of 1320) at 1 year, and 60% (639 of 1066 survivors) at the fifth year. Forty percent of the subjects did not respond to the questionnaires or were not included in the fifth-year survey. What if those nonresponders in the fifth year have a completely different sense of well-being?Patients with breast cancer in the early stages, similar to the subjects in the two studies, may show a disease-free survival of
Ryo UY. Follow-up of Patients With Breast Cancer. JAMA. 1994;272(21):1658. doi:10.1001/jama.1994.03520210041024