An audit of staging investigations for breast cancer
Association of Breast Surgery ePoster Library. Simpson D. 05/15/17; 166173; P144
Mr. Duncan Simpson
REGULAR CONTENT
Login now to access Regular content available to all registered users.
Abstract
Rate & Comment (0)
Introduction
Our protocol for staging in breast cancer is US abdomen and CXR in patients if clinically node negative, and CT and bone scan if clinically node positive. ABS guidelines suggest that US and bone scan are not useful unless symptomatic, part of a trial, or to undergo neoadjuvant treatment. We wanted to assess our protocol against this standard.
Methods
All patients diagnosed with breast cancer in 2015 were identified. Demographics; decision to operate; pre-operative node status; staging investigations and subsequent changes to management were recorded.
Results
258 patients were diagnosed with breast cancer in 2015. 2 male. Age range 30-86 (median 62). In 29 patients no surgery was planned. 33 patients had in-situ disease only and had no staging. The remaining 196 patients were planned for surgery. All had staging.
160 were clinically node negative:
149 had US, 150 had CXR, 21 had CT, 5 had bone scan
No patient in this group had metastases detected.
36 were clinically node positive:
36 had CT, 35 had bone scan
5 of these patients had metastases on CT. 4 had metastases on bone scan (all also on CT). 2 of these 5 patients had their management changed from operative to non-operative.
Conclusions
No clinically node negative patient had metastases diagnosed. No patient had metastases on US. No patient had metastases on bone scan that were not on CT.
We recommend no staging if clinically node negative and no routine use of US, CXR or bone scan. We estimate savings around £60,000/year.
Our protocol for staging in breast cancer is US abdomen and CXR in patients if clinically node negative, and CT and bone scan if clinically node positive. ABS guidelines suggest that US and bone scan are not useful unless symptomatic, part of a trial, or to undergo neoadjuvant treatment. We wanted to assess our protocol against this standard.
Methods
All patients diagnosed with breast cancer in 2015 were identified. Demographics; decision to operate; pre-operative node status; staging investigations and subsequent changes to management were recorded.
Results
258 patients were diagnosed with breast cancer in 2015. 2 male. Age range 30-86 (median 62). In 29 patients no surgery was planned. 33 patients had in-situ disease only and had no staging. The remaining 196 patients were planned for surgery. All had staging.
160 were clinically node negative:
149 had US, 150 had CXR, 21 had CT, 5 had bone scan
No patient in this group had metastases detected.
36 were clinically node positive:
36 had CT, 35 had bone scan
5 of these patients had metastases on CT. 4 had metastases on bone scan (all also on CT). 2 of these 5 patients had their management changed from operative to non-operative.
Conclusions
No clinically node negative patient had metastases diagnosed. No patient had metastases on US. No patient had metastases on bone scan that were not on CT.
We recommend no staging if clinically node negative and no routine use of US, CXR or bone scan. We estimate savings around £60,000/year.
Introduction
Our protocol for staging in breast cancer is US abdomen and CXR in patients if clinically node negative, and CT and bone scan if clinically node positive. ABS guidelines suggest that US and bone scan are not useful unless symptomatic, part of a trial, or to undergo neoadjuvant treatment. We wanted to assess our protocol against this standard.
Methods
All patients diagnosed with breast cancer in 2015 were identified. Demographics; decision to operate; pre-operative node status; staging investigations and subsequent changes to management were recorded.
Results
258 patients were diagnosed with breast cancer in 2015. 2 male. Age range 30-86 (median 62). In 29 patients no surgery was planned. 33 patients had in-situ disease only and had no staging. The remaining 196 patients were planned for surgery. All had staging.
160 were clinically node negative:
149 had US, 150 had CXR, 21 had CT, 5 had bone scan
No patient in this group had metastases detected.
36 were clinically node positive:
36 had CT, 35 had bone scan
5 of these patients had metastases on CT. 4 had metastases on bone scan (all also on CT). 2 of these 5 patients had their management changed from operative to non-operative.
Conclusions
No clinically node negative patient had metastases diagnosed. No patient had metastases on US. No patient had metastases on bone scan that were not on CT.
We recommend no staging if clinically node negative and no routine use of US, CXR or bone scan. We estimate savings around £60,000/year.
Our protocol for staging in breast cancer is US abdomen and CXR in patients if clinically node negative, and CT and bone scan if clinically node positive. ABS guidelines suggest that US and bone scan are not useful unless symptomatic, part of a trial, or to undergo neoadjuvant treatment. We wanted to assess our protocol against this standard.
Methods
All patients diagnosed with breast cancer in 2015 were identified. Demographics; decision to operate; pre-operative node status; staging investigations and subsequent changes to management were recorded.
Results
258 patients were diagnosed with breast cancer in 2015. 2 male. Age range 30-86 (median 62). In 29 patients no surgery was planned. 33 patients had in-situ disease only and had no staging. The remaining 196 patients were planned for surgery. All had staging.
160 were clinically node negative:
149 had US, 150 had CXR, 21 had CT, 5 had bone scan
No patient in this group had metastases detected.
36 were clinically node positive:
36 had CT, 35 had bone scan
5 of these patients had metastases on CT. 4 had metastases on bone scan (all also on CT). 2 of these 5 patients had their management changed from operative to non-operative.
Conclusions
No clinically node negative patient had metastases diagnosed. No patient had metastases on US. No patient had metastases on bone scan that were not on CT.
We recommend no staging if clinically node negative and no routine use of US, CXR or bone scan. We estimate savings around £60,000/year.
Code of conduct/disclaimer available in General Terms & Conditions
{{ help_message }}
{{filter}}