Value of routine staging imaging studies for patients with stage III breast cancer

Piatek, Caroline I.; Ji, Lingyun; Kaur, Chandan; Russell, Christy; Tripathy, Debu; Church, Terry David; Sposto, Richard; Sener, Stephen F.; García, Agustin A.

doi:10.1002/jso.24436

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…The 9% yield in these cases supports the view that ABCs may undergo CTC for staging. Our result is comparable to those from Piatek et al (5%) and Kim et al (6%) [5, 27].…”

Section: Discussionsupporting

confidence: 89%

A critical review of the chest CT scans performed to detect asymptomatic synchronous metastasis in new and recurrent breast cancers

et al. 2019

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Background Chest computed tomography (CTC) has now replaced chest X-ray (CXR) as the first choice of investigation to stage breast cancers in most centers in Australia. Routine staging is not recommended in early breast cancers (EBCs). This recommendation is based largely on the use of conventional tests like CXR as staging investigations (SIs). We looked at our experience with CTC in detecting asymptomatic synchronous distant metastasis (ASM) in new and recurrent breast cancers (RBCs). Materials and methods Breast cancer patients from Eastern Health Breast Unit during the period from January 2012 to March 2016 were included in the study. Cases were grouped into early, advanced, and recurrent breast cancers, and outcome of CTC was assessed in each group. Relative risk of potential risk factors (tumor size, axillary nodal status, presence of lymphovascular invasion and estrogen, and HER2 receptor status) with a positive result in CTC was determined. Results Fourteen ASMs were detected from 335 CTCs giving an overall yield of 4% (95% CI 1.89–6.47). The overall false-positive rate was 10% due to 35 indeterminate findings that were found not to be metastases after further tests or observation. Even with selective use, CTCs have a low yield of 2% (95% CI − 0.19–4.19) in EBCs. Advanced breast cancers have a 9% incidence of ASMs. None of the clinically isolated locoregionally recurrent diseases were associated with detectable distant metastasis in CTC. The most common cause of indeterminate findings was small pulmonary nodules. Conclusion Even with selective use, CTC has a very low yield in EBCs. Advanced breast cancers can benefit from CTC in their initial evaluation due to the higher yield. Locoregional RBCs were not usually associated with detectable metastasis on CTC. The usefulness of CTC in all stages of breast cancer is further reduced by its high rate of false-positive results.

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“…The 9% yield in these cases supports the view that ABCs may undergo CTC for staging. Our result is comparable to those from Piatek et al (5%) and Kim et al (6%) [5, 27].…”

Section: Discussionsupporting

confidence: 89%

A critical review of the chest CT scans performed to detect asymptomatic synchronous metastasis in new and recurrent breast cancers

et al. 2019

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“…Thirty-two studies assessing imaging modalities [anatomic: chest radiography, liver ultrasonography, chestabdomen-pelvis computed tomography (ct); metabolic: integrated positron-emission tomography (pet)/ct, integrated pet/magnetic resonance imaging (mri), bone scintigraphy] for staging in women with newly diagnosed bca and reporting the outcomes of interest were retained: one systematic review 12 , fourteen prospective cohort studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26] , and seventeen retrospective studies [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] . The study population comprised women with all presentations of bca (including locally advanced bca 14,15,17,20,21,26 , inflammatory bca 21 , and invasive lobular and ductal carcinoma 35 ) and a mixed population of newly diagnosed bca.…”

Section: Literature Searchmentioning

confidence: 99%

“…The reference standard was considered on the basis of clinical and short-term follow-up imaging of metastatic lesions, or on the judgment of a multidisciplinary tumour board when biopsy or histopathology was not feasible, or both, because no "gold standard" for the detection of real metastases has been established. Fifteen studies did not provide enough information to determine whether the results of the reference standard test were blinded to the results of the index test 15,17,19,20,23,26,[30][31][32]34,[38][39][40][41]43 , and the risk for bias is related to the potential influence of previous knowledge on test interpretation 44 .…”

Section: Primary Literaturementioning

confidence: 99%

“…One study was judged to have high risk of bias because only a proportion of suspicious findings received confirmation of the diagnosis by the test used as the reference standard, which might lead to verification bias 32 . The other six studies did not provide sufficient information to determine whether suspicious findings were confirmed by the reference standard or whether all patients with suspected metastasis received the same reference standard 21,25,30,31,40,42 .…”

Section: Primary Literaturementioning

confidence: 99%

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Baseline Staging Imaging for Distant Metastasis in Women with Stages I, II, and III Breast Cancer

et al. 2020

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Background In Ontario, there is no clearly defined standard of care for staging for distant metastasis in women with newly diagnosed and biopsy-confirmed breast cancer whose clinical presentation is suggestive of early-stage disease. This guideline addresses baseline imaging investigations for women with newly diagnosed primary breast cancer who are otherwise asymptomatic for distant metastasis. Methods The medline and embase databases were systematically searched for evidence from January 2000 to April 2019, and the best available evidence was used to draft recommendations relevant to the use of baseline imaging investigation in women with newly diagnosed primary breast cancer who are otherwise asymptomatic. Final approval of this practice guideline was obtained from both the Staging in Early Stage Breast Cancer Advisory Committee and the Report Approval Panel of the Program in Evidence-Based Care. Recommendations These recommendations apply to all women with newly diagnosed primary breast cancer (originating in the breast) who have no symptoms of distant metastasis Staging tests using conventional anatomic imaging [chest radiography, liver ultrasonography, chest–abdomen– pelvis computed tomography (ct)] or metabolic imaging modalities [integrated positron-emission tomography (pet)/ct, integrated pet/magnetic resonance imaging (mri), bone scintigraphy] should not be routinely ordered for women newly diagnosed with clinical stage i or stage ii breast cancer who have no symptoms of distant metastasis, regardless of biomarker status. In women newly diagnosed with stage iii breast cancer, baseline staging tests using either anatomic imaging (chest radiography, liver ultrasonography, chest–abdomen–pelvis ct) or metabolic imaging modalities (pet/ct, pet/ mri, bone scintigraphy) should be considered regardless of whether the patient is symptomatic for distant metastasis and regardless of biomarker profile.

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ACR Appropriateness Criteria® Imaging of Invasive Breast Cancer

McDonald,

Scheel,

Lewin

et al. 2024

Journal of the American College of Radiology

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Value of routine staging imaging studies for patients with stage III breast cancer

Cited by 4 publications

References 19 publications

A critical review of the chest CT scans performed to detect asymptomatic synchronous metastasis in new and recurrent breast cancers

A critical review of the chest CT scans performed to detect asymptomatic synchronous metastasis in new and recurrent breast cancers

Baseline Staging Imaging for Distant Metastasis in Women with Stages I, II, and III Breast Cancer

ACR Appropriateness Criteria® Imaging of Invasive Breast Cancer

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