Bone Scan and Liver Ultrasound Scan in the Preoperative Staging for Primary Breast Cancer

Abstract

The aim of the present study was to investigate the value of preoperative staging in primary operable breast cancer. This retrospective study included patients presenting between May 1999 and February 2004 with operable primary breast cancer. Of the 221 patients 189 had normal and 32 suspicious or positive bone scans (BS). Of the 189 patients with normal BS 182 had normal liver ultrasound (US), whereas the remaining seven patients underwent computed tomography scan which was normal in five and two confirmed liver metastases (one with abnormal LFTs). Of the 32 patients with suspicious or positive BS 26 were false positive on further investigations and the remaining six patients were confirmed to have bony metastasis (one abnormal bone profile). BS and liver US truly altered treatment in 3% of patients. False-positive results caused delay, psychological upset, and costly investigations in 14% of cases. Preoperative staging with liver US and BS should be reserved for high-risk patients.

18F-FDG PET/CT as a staging procedure in primary stage II and III breast cancer: comparison with conventional imaging techniques

“…Ultrasound of the liver is considered an accurate procedure in the detection of liver metastases, but the low incidence of liver metastases and the combination of PET and CT may render it unnecessary [7,11,25]. This study shows a low incidence of liver metastases and a good performance of ultrasound of the liver: liver metastases were detected in two patients (2%), whereas no missed metastases or false positive lesions were perceived.…”

“…Therefore, it is standard practice to perform a search for distant disease prior to an intensive treatment regime with curative intent [9,10]. Different imaging techniques, such as bone scintigraphy, ultrasound of the liver, chest radiography, and computed tomography (CT) scans, are currently used for this purpose [7,9,11]. Since the development of PET (positron emission tomography) and, later, PET/CT (PET with integrated computed tomography) with the use of 18F-fluorodeoxyglucose (18F-FDG), several studies have been carried out comparing both techniques to conventional imaging procedures [12][13][14][15][16][17][18][19].…”

The value of preoperative staging chest computed tomography to detect asymptomatic lung and liver metastasis in patients with primary breast carcinoma

“…There is no clear evidence to support the routine use of imaging to detect the presence of metastases in the baseline staging of patients with primary operable breast cancer [9][10][11][12][13][14]. NCCN guidelines suggest that staging investigations including chest imaging are not required in patients with asymptomatic early stage breast cancer, and should only be considered in those with T3, N1, M0 (stage IIIA) or locally advanced breast cancer, or pulmonary symptoms [5].…”

Use and Yield of Baseline Imaging and Laboratory Testing in Stage II Breast Cancer

“…In a more recent study from Ontario, Canada, in 2012, approximately 35% of patients with stage II BC underwent chest CT for staging and 40% had abdominal/pelvis CT [3]. Furthermore, although LFT is recommended by the NCCNto screen foroccult metastatic disease, limited data support this recommendation [5].…”