R Samant1, P Ganguly. 1. Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, Canada. rsamant@neorcc.on.ca
Abstract
HYPOTHESIS: Metastatic workup for patients newly diagnosed as having breast cancer is variable, especially for early disease (T1-2 N0-1). Routine bone scans and liver imaging are often performed without any evidence to support their usefulness. DESIGN: A retrospective review of patients with breast cancer referred to our center during a 2-year period was performed to determine the value of staging investigations in detecting metastases. RESULTS: Of the total 250 patients referred to our center after initial diagnosis, 25 (10.0%) were diagnosed as having metastases, 23 of whom had either clinical symptoms or signs suggestive of metastatic disease or abnormalities on routine blood work or chest x-ray examinations. Only 2 patients with metastatic disease were diagnosed solely on bone scan results; none were diagnosed solely on liver imaging (either with an ultrasound or radionuclide isotope liver scan). Overall, 3% (5/161) of patients with pathologic T1-2 N0-1 disease had metastases diagnosed compared with 30% (18/61) of patients with pathologic stage T3-4 or N2 disease. CONCLUSIONS: Our results confirm the low yield of routine bone scans and liver imaging among patients with asymptomatic, pathologically confirmed, early stage (T1-2 N0-1) breast cancer. Therefore, we do not recommend these tests for such patients, although intensive investigations are appropriate for more advanced (stage T3-4 or N2) tumors.
HYPOTHESIS: Metastatic workup for patients newly diagnosed as having breast cancer is variable, especially for early disease (T1-2 N0-1). Routine bone scans and liver imaging are often performed without any evidence to support their usefulness. DESIGN: A retrospective review of patients with breast cancer referred to our center during a 2-year period was performed to determine the value of staging investigations in detecting metastases. RESULTS: Of the total 250 patients referred to our center after initial diagnosis, 25 (10.0%) were diagnosed as having metastases, 23 of whom had either clinical symptoms or signs suggestive of metastatic disease or abnormalities on routine blood work or chest x-ray examinations. Only 2 patients with metastatic disease were diagnosed solely on bone scan results; none were diagnosed solely on liver imaging (either with an ultrasound or radionuclide isotope liver scan). Overall, 3% (5/161) of patients with pathologic T1-2 N0-1 disease had metastases diagnosed compared with 30% (18/61) of patients with pathologic stage T3-4 or N2 disease. CONCLUSIONS: Our results confirm the low yield of routine bone scans and liver imaging among patients with asymptomatic, pathologically confirmed, early stage (T1-2 N0-1) breast cancer. Therefore, we do not recommend these tests for such patients, although intensive investigations are appropriate for more advanced (stage T3-4 or N2) tumors.
Authors: Naoki Niikura; Jun Liu; Colleen M Costelloe; Shana L Palla; John E Madewell; Naoki Hayashi; Tse-Kuan Yu; Yutaka Tokuda; Richard L Theriault; Gabriel N Hortobagyi; Naoto T Ueno Journal: Oncologist Date: 2011-05-31
Authors: Demetrios Simos; Brian Hutton; Ian D Graham; Angel Arnaout; Jean-Michel Caudrelier; Sasha Mazzarello; Mark Clemons Journal: Springerplus Date: 2014-04-05