Purpose In patients with ipsilateral breast tumor recurrence (IBTR), the detection of distant disease determines whether the intention of the treatment is curative or palliative. Therefore, adequate preoperative staging is imperative for optimal treatment planning. The aim of this study is to evaluate the impact of conventional imaging techniques, including chest X-ray and/or CT thorax-(abdomen), liver ultrasonography(US), and skeletal scintigraphy, on the distant recurrence-free interval (DRFI) in patients with IBTR, and to compare conventional imaging with 18 F-FDG PET-CT or no imaging at all. Methods This study was exclusively based on the information available at time of diagnoses of IBTR. To adjust for differences in baseline characteristics between the three imaging groups, a propensity score (PS) weighted method was used. Results Of the 495 patients included in the study, 229 (46.3%) were staged with conventional imaging, 89 patients (19.8%) were staged with 18 F-FDG PET-CT, and in 168 of the patients (33.9%) no imaging was used ( N = 168). After a follow-up of approximately 5 years, 14.5% of all patients developed a distant recurrence as first event after IBTR. After adjusting for the PS weights, the Cox regression analyses showed that the different staging methods had no significant impact on the DRFI. Conclusions This study showed a wide variation in the use of imaging modalities for staging IBTR patients in the Netherlands. After using PS weighting, no statistically significant impact of the different imaging modalities on DRFI was shown. Based on these results, it is not possible to recommend staging for distant metastases using 18 F-FDG PET-CT over conventional imaging techniques. Electronic supplementary material The online version of this article (10.1007/s10549-019-05205-z) contains supplementary material, which is available to authorized users.

Background: To investigate whether the implementation of additional modern information tools about cosmetic outcome of breast-conserving treatment (BCT) could improve patient satisfaction. Methods: A comparative case study compared data of two cross-sectional studies. The historical group (HG) was treated in 2013, the implementation group (IG) in 2016. The HG received a questionnaire, which resulted in implementation of the following items in our practice, expansion of the BCT brochure and photo book, incorporation of the Harvard and Numeric Rating scale. The IG received the same questionnaire, with the addition of nine more questions concerning specific implementation aspects. Results: The HG contained 76 patients (age 41-86), versus 57 in the IG (age 40-84). Although additional information tools were implemented, no significant enhancement of IG patient satisfaction could be demonstrated. Nevertheless, the need for information appeared significantly greater (p < 0.001) in the IG. Conclusion: The need for information about cosmesis was greater in the IG, possibly due to increased attention paid by professionals. Furthermore, it is difficult to improve an information program concerning cosmetic consequences of BCT, despite the implementation of better tools. Professionals should focus on individual cosmetic outcome information during the entire treatment and follow up process of BCT.