Reevaluation of baseline staging tests in breast cancer; what should be the standart?

Abstract

There has been an ongoing debate on staging in breast cancer. In this study, we evaluated the metastasis détection rate with baseline staging of breast cancer after operation. One hundred consecutive breast cancer patients were evaluated with liver ultrasonography, chest X-ray and bone scans. All patients were followed at least for 6 months. More than one third of our patients belong to the high risk group (axillary involvement >3). In 3 patients (3%) metastasis were detected. Two of them (5,8%) were in the group with pT4, N2 or N1 (N >3), one of them (2,7%) was in the group with pT2-3NO-1 (N s3). There was no metastasis in patients with pT1 NO-1 (N s3). To detect one case of occult metastasis 2000 euro were spent. As a result, routine staging does not have a major impact on individual adjuvant treatment planning. We recommend routine staging only for patients with pT4 or N1, (N >3) or N2 disease, and we do not recommend staging for patients with pT1NO-1, (N s3) positive nodes. Decision about staging of the patients with pT2-3NO-1, (N <3) diseases should be individualized according to patients' and doctors' preferences and economic resources.