Metastatic screening for patients with newly diagnosed breast cancer : who and how?
Date
2020-04-06
Journal Title
Journal ISSN
Volume Title
Publisher
AOSIS
Abstract
Background: Staging for breast cancer patients, as defined by the American Joint Committee on Cancer (AJCC), has historically been limited to anatomical staging. However, the eighth version of the AJCC guidelines has been altered to include tumour biology. Anatomical staging still has a place especially in low-middle income countries where the majority of patients present with locally advanced or metastatic disease.
Aim: This review article considers which newly diagnosed breast cancer patients should be referred for anatomical staging and the pros and cons of the different modalities available in South Africa.
Method: The different modalities available were reviewed with respect to metastatic screening for asymptomatic women. The usefulness of the modalities were considered with reference to organ-specific disease rather than the stage of the patient.
Results: Any person with newly diagnosed breast cancer and symptoms suggestive of systemic involvement should be investigated. All symptomatic women who present with a tumour larger than 5 cm, radiological or clinical evidence of nodal disease, triple negative or HER2+ve tumours should have metastatic screening. This gives information about the primary as well as the metastatic status.
Conclusion: However, increasingly, the major determinant of treatment is the biology of the cancer and not the anatomical stage. In future, this trend is likely to increase with anatomical staging becoming less important.
Description
CITATION: Edge, J. et al. 2020. Metastatic screening for patients with newly diagnosed breast cancer : who and how? South African Journal of Oncology, 4:a94, doi:10.4102/sajo.v4i0.94.
The original publication is available at https://sajo.org.za
The original publication is available at https://sajo.org.za
Keywords
Breast cancer, Metastatic disease, Breast cancer — diagnosis, Medical screening — Guidelines
Citation
Edge, J. et al. 2020. Metastatic screening for patients with newly diagnosed breast cancer : who and how? South African Journal of Oncology, 4:a94, doi:10.4102/sajo.v4i0.94.