Diagnostic performance of additional imaging tests for staging purposes in a bicentric German series of low-risk early breast cancer patients

Abstract

Abstract Purpose Low-risk early breast cancer rarely leads to the development of metastatic disease and in these patients, additional imaging test are controversial. The aim of our study was to evaluate conventional staging procedures in a bicentric German series of low-risk breast carcinoma patients. Methods Retrospective evaluation of all patients diagnosed with early, low-risk breast cancer at Saarland University Hospital and Freiburg University Hospital in 2017 was performed. Clinical patient characteristics, the number and type of additional imaging examinations, follow-up examinations and results were evaluated. The detection rate of metastases and the rate of false positive findings were analyzed. Results A total of 203 patients were included, with all patients received at least one additional imaging test. Initially, a total of 562 additional imaging examinations were performed: 166 chest x-rays, 169 upper abdominal ultrasounds, 199 bone scans, 27 computer tomographies (CT) chest and abdomen, 1 CT abdomen. 6.8% of patients had abnormal findings reported, requiring 38 additional imaging examinations. One patient (0.5%) was found to have bone metastases. The rate of false-positive findings in the performed additional imaging procedures was 6.6%. Conclusion Metastatic disease was detected in one of 203 patients with low-risk early breast cancer. A total of 562 examinations and additional 38 follow-up examinations were performed without detection of metastasis (this corresponds to approximately 3 examinations/patient). The rate of false-positive findings was 6.6%. The performance of additional imaging procedures for detection of distant metastases should be critically reconsidered in patients with low-risk early breast cancer.