Newly diagnosed early breast cancer - an update on pre-operative assessment and staging.

BACKGROUND: Most breast cancer seen in developed nations is diagnosed at an early stage and surgery is the recommended first line treatment in most cases.
OBJECTIVE: This article reviews the current approach and related evidence on pre-operative assessment of women with newly diagnosed breast cancer. It discusses the use of conventional assessment tools (mammography, ultrasound and needle biopsy) for staging the breast and axilla, the evidence relating to breast magnetic resonance imaging and the indications for staging investigations for distant metastatic disease. It highlights recent changes in practice, including areas of nonconsensus, and informs general practitioners on evolving issues in the pre-operative care of the newly diagnosed breast cancer patient. DISCUSSION: Once a breast cancer diagnosis has been established, appropriate pre-operative evaluation to assess the extent of disease (locally and sometimes systemically) helps guide surgical management and decisions on adjuvant therapy.