Baseline staging imaging for distant metastasis in women with stage I, II, and III breast cancer

  • A. Arnaout The Ottawa Hospital and The University of Ottawa
  • N.P. Varela Cancer Care Ontario, McMaster University.
  • M. Allarakhia The Ottawa Hospital
  • L. Grimard The Ottawa Hospital
  • A. Hey Northeast Cancer Centre
  • J. Lau The University of Ottawa
  • L. Thain Ontario Health (Cancer Care Ontario) Regional Imaging, Southlake Regional Health Centre, Newmarket, and Mackenzie Health
  • A. Eisen Sunnybrook Health Sciences Centre
Keywords: Baseline staging, imaging, distant metastasis, early stage, breast cancer

Abstract

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.


Author Biographies

A. Arnaout, The Ottawa Hospital and The University of Ottawa

Department of Surgery

N.P. Varela, Cancer Care Ontario, McMaster University.

Program in Evidence-based Care

L. Grimard, The Ottawa Hospital

Department of Radiation Medicine

A. Hey, Northeast Cancer Centre

Regional Primary Care

J. Lau, The University of Ottawa

Department of Radiology

A. Eisen, Sunnybrook Health Sciences Centre

Division of Medical Oncology

Published
2020-01-16
How to Cite
Arnaout, A., Varela, N., Allarakhia, M., Grimard, L., Hey, A., Lau, J., Thain, L., & Eisen, A. (2020). Baseline staging imaging for distant metastasis in women with stage I, II, and III breast cancer. Current Oncology, 27(2). https://doi.org/10.3747/co.27.6147
Section
Practice Guideline