Meme Kanseri Sonrası İzlem
Özet
Meme kanseri tedavisi sonrası izlem; lokal nüks ve metastazların erken tanısı, ikincil primerlerin saptanması, tedaviye bağlı geç toksisitelerin yönetimi ve yaşam kalitesinin korunmasını amaçlayacak şekilde çok yönlü bir süreçtir. Esas bileşenler ayrıntılı anamnez ve fizik muayenedir; asemptomatik hastada rutin laboratuvar, tümör belirteci ve sistemik görüntüleme önerilmemektedir. Görüntülemenin omurgası mamografidir: ultrasonografi ve MRG’nin katkısı özel hasta gruplarıyla sınırlıdır. İlk 3 yıl 3–6 ayda bir, 4–5. yıllar 6–12 ayda bir, sonrasında yıllık kontrol uygundur; risk profiline göre kişiselleştirilir. İzlemde kemik sağlığı, lenfödem, nöropati, kardiyotoksisite ve ikincil kanserler için tarama ve önlemler planlanır. Fertilite, gebelik zamanlaması ve kontrasepsiyon kanıta dayalı yönetilir; psikososyal destek ve yaşam tarzı müdahaleleri nüks riskini ve semptom yükünü azaltır. Erkek hastalarda da yıllık mamografi ve genetik danışmanlık önerilir. Genel yaklaşım yalın, kanıta dayalı ve bireyselleştirilmiş olmalıdır.
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