Staging of breast cancer: New recommended standard procedure

Alberto Ravaioli, Giuseppe Pasini, Antonio Polselli, Maximilian Papi, Davide Tassinari, Valentina Arcangeli, Carlo Milandri, Dino Amadori, Matteo Bravi, Daniela Rossi, Pier Paolo Fattori, Enzo Pasquini, Ilaria Panzini

Research output: Contribution to journalArticle

Abstract

Background. Staging procedures used to detect metastatic breast cancer at the time of diagnosis are bone scan (BS), chest X-ray (CXR), liver ultrasonography (LUS) and laboratory parameters (LP). These procedures are expensive and not all patients need them. We aimed to identify groups of patients with different risks for metastatic disease. Methods. We reviewed data from 1,218 consecutive cases of breast cancer. Pathological and biological parameters and instrumental procedures performed at the time of diagnosis and during 6 months of follow-up were recorded. True positive and negative, false positive and negative cases were evaluated. All cases were grouped on the basis of tumour size, nodal involvement, biological characteristics, menopausal status and age. Results. We observed 46 (3.8%) true positive cases with metastatic disease at the time of diagnosis. Documentation relating to BS, CXR and LUS was available for 1,193, 1,206 and 1,206 patients, respectively, with 37 (3.1%), 8 (0.7%) and 10 (0.8%) true positive tests. Logistic regression analysis showed significant odds ratio estimates for pT status and nodal status, thus highlighting the role of these morphological data. These findings suggest that breast cancer patients can be divided into two subgroups: first group pT1-3N0-I, with ≤3 involved nodes, and second group pT1-3N1 with ≥4 involved nodes, pT4 and pN2 (metastases detection rate 1.46 and 10.68%, respectively). In the former group the appropriate procedures of staging would only be laboratory parameters, whereas in the latter group BS, CXR, LUS, LP and tumour markers CEA and CA15.3 would be necessary. Conclusions. The standard staging procedures to detect metastatic disease at breast cancer diagnosis require modification. On the basis of the literature data and our findings, the full staging procedure is appropriate in the second group of patients.

Original languageEnglish
Pages (from-to)53-60
Number of pages8
JournalBreast Cancer Research and Treatment
Volume72
Issue number1
DOIs
Publication statusPublished - 2002

Fingerprint

Breast Neoplasms
Ultrasonography
Thorax
X-Rays
Bone and Bones
Liver
Tumor Biomarkers
Documentation
Biomarkers
Logistic Models
Odds Ratio
Regression Analysis
Neoplasm Metastasis
Neoplasms

Keywords

  • Bone scan
  • Breast cancer
  • Chest X-ray
  • Staging
  • Ultrasonography

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Ravaioli, A., Pasini, G., Polselli, A., Papi, M., Tassinari, D., Arcangeli, V., ... Panzini, I. (2002). Staging of breast cancer: New recommended standard procedure. Breast Cancer Research and Treatment, 72(1), 53-60. https://doi.org/10.1023/A:1014900600815

Staging of breast cancer : New recommended standard procedure. / Ravaioli, Alberto; Pasini, Giuseppe; Polselli, Antonio; Papi, Maximilian; Tassinari, Davide; Arcangeli, Valentina; Milandri, Carlo; Amadori, Dino; Bravi, Matteo; Rossi, Daniela; Fattori, Pier Paolo; Pasquini, Enzo; Panzini, Ilaria.

In: Breast Cancer Research and Treatment, Vol. 72, No. 1, 2002, p. 53-60.

Research output: Contribution to journalArticle

Ravaioli, A, Pasini, G, Polselli, A, Papi, M, Tassinari, D, Arcangeli, V, Milandri, C, Amadori, D, Bravi, M, Rossi, D, Fattori, PP, Pasquini, E & Panzini, I 2002, 'Staging of breast cancer: New recommended standard procedure', Breast Cancer Research and Treatment, vol. 72, no. 1, pp. 53-60. https://doi.org/10.1023/A:1014900600815
Ravaioli A, Pasini G, Polselli A, Papi M, Tassinari D, Arcangeli V et al. Staging of breast cancer: New recommended standard procedure. Breast Cancer Research and Treatment. 2002;72(1):53-60. https://doi.org/10.1023/A:1014900600815
Ravaioli, Alberto ; Pasini, Giuseppe ; Polselli, Antonio ; Papi, Maximilian ; Tassinari, Davide ; Arcangeli, Valentina ; Milandri, Carlo ; Amadori, Dino ; Bravi, Matteo ; Rossi, Daniela ; Fattori, Pier Paolo ; Pasquini, Enzo ; Panzini, Ilaria. / Staging of breast cancer : New recommended standard procedure. In: Breast Cancer Research and Treatment. 2002 ; Vol. 72, No. 1. pp. 53-60.
@article{3ca3382b78cf4e14a6958f03ff212251,
title = "Staging of breast cancer: New recommended standard procedure",
abstract = "Background. Staging procedures used to detect metastatic breast cancer at the time of diagnosis are bone scan (BS), chest X-ray (CXR), liver ultrasonography (LUS) and laboratory parameters (LP). These procedures are expensive and not all patients need them. We aimed to identify groups of patients with different risks for metastatic disease. Methods. We reviewed data from 1,218 consecutive cases of breast cancer. Pathological and biological parameters and instrumental procedures performed at the time of diagnosis and during 6 months of follow-up were recorded. True positive and negative, false positive and negative cases were evaluated. All cases were grouped on the basis of tumour size, nodal involvement, biological characteristics, menopausal status and age. Results. We observed 46 (3.8{\%}) true positive cases with metastatic disease at the time of diagnosis. Documentation relating to BS, CXR and LUS was available for 1,193, 1,206 and 1,206 patients, respectively, with 37 (3.1{\%}), 8 (0.7{\%}) and 10 (0.8{\%}) true positive tests. Logistic regression analysis showed significant odds ratio estimates for pT status and nodal status, thus highlighting the role of these morphological data. These findings suggest that breast cancer patients can be divided into two subgroups: first group pT1-3N0-I, with ≤3 involved nodes, and second group pT1-3N1 with ≥4 involved nodes, pT4 and pN2 (metastases detection rate 1.46 and 10.68{\%}, respectively). In the former group the appropriate procedures of staging would only be laboratory parameters, whereas in the latter group BS, CXR, LUS, LP and tumour markers CEA and CA15.3 would be necessary. Conclusions. The standard staging procedures to detect metastatic disease at breast cancer diagnosis require modification. On the basis of the literature data and our findings, the full staging procedure is appropriate in the second group of patients.",
keywords = "Bone scan, Breast cancer, Chest X-ray, Staging, Ultrasonography",
author = "Alberto Ravaioli and Giuseppe Pasini and Antonio Polselli and Maximilian Papi and Davide Tassinari and Valentina Arcangeli and Carlo Milandri and Dino Amadori and Matteo Bravi and Daniela Rossi and Fattori, {Pier Paolo} and Enzo Pasquini and Ilaria Panzini",
year = "2002",
doi = "10.1023/A:1014900600815",
language = "English",
volume = "72",
pages = "53--60",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York LLC",
number = "1",

}

TY - JOUR

T1 - Staging of breast cancer

T2 - New recommended standard procedure

AU - Ravaioli, Alberto

AU - Pasini, Giuseppe

AU - Polselli, Antonio

AU - Papi, Maximilian

AU - Tassinari, Davide

AU - Arcangeli, Valentina

AU - Milandri, Carlo

AU - Amadori, Dino

AU - Bravi, Matteo

AU - Rossi, Daniela

AU - Fattori, Pier Paolo

AU - Pasquini, Enzo

AU - Panzini, Ilaria

PY - 2002

Y1 - 2002

N2 - Background. Staging procedures used to detect metastatic breast cancer at the time of diagnosis are bone scan (BS), chest X-ray (CXR), liver ultrasonography (LUS) and laboratory parameters (LP). These procedures are expensive and not all patients need them. We aimed to identify groups of patients with different risks for metastatic disease. Methods. We reviewed data from 1,218 consecutive cases of breast cancer. Pathological and biological parameters and instrumental procedures performed at the time of diagnosis and during 6 months of follow-up were recorded. True positive and negative, false positive and negative cases were evaluated. All cases were grouped on the basis of tumour size, nodal involvement, biological characteristics, menopausal status and age. Results. We observed 46 (3.8%) true positive cases with metastatic disease at the time of diagnosis. Documentation relating to BS, CXR and LUS was available for 1,193, 1,206 and 1,206 patients, respectively, with 37 (3.1%), 8 (0.7%) and 10 (0.8%) true positive tests. Logistic regression analysis showed significant odds ratio estimates for pT status and nodal status, thus highlighting the role of these morphological data. These findings suggest that breast cancer patients can be divided into two subgroups: first group pT1-3N0-I, with ≤3 involved nodes, and second group pT1-3N1 with ≥4 involved nodes, pT4 and pN2 (metastases detection rate 1.46 and 10.68%, respectively). In the former group the appropriate procedures of staging would only be laboratory parameters, whereas in the latter group BS, CXR, LUS, LP and tumour markers CEA and CA15.3 would be necessary. Conclusions. The standard staging procedures to detect metastatic disease at breast cancer diagnosis require modification. On the basis of the literature data and our findings, the full staging procedure is appropriate in the second group of patients.

AB - Background. Staging procedures used to detect metastatic breast cancer at the time of diagnosis are bone scan (BS), chest X-ray (CXR), liver ultrasonography (LUS) and laboratory parameters (LP). These procedures are expensive and not all patients need them. We aimed to identify groups of patients with different risks for metastatic disease. Methods. We reviewed data from 1,218 consecutive cases of breast cancer. Pathological and biological parameters and instrumental procedures performed at the time of diagnosis and during 6 months of follow-up were recorded. True positive and negative, false positive and negative cases were evaluated. All cases were grouped on the basis of tumour size, nodal involvement, biological characteristics, menopausal status and age. Results. We observed 46 (3.8%) true positive cases with metastatic disease at the time of diagnosis. Documentation relating to BS, CXR and LUS was available for 1,193, 1,206 and 1,206 patients, respectively, with 37 (3.1%), 8 (0.7%) and 10 (0.8%) true positive tests. Logistic regression analysis showed significant odds ratio estimates for pT status and nodal status, thus highlighting the role of these morphological data. These findings suggest that breast cancer patients can be divided into two subgroups: first group pT1-3N0-I, with ≤3 involved nodes, and second group pT1-3N1 with ≥4 involved nodes, pT4 and pN2 (metastases detection rate 1.46 and 10.68%, respectively). In the former group the appropriate procedures of staging would only be laboratory parameters, whereas in the latter group BS, CXR, LUS, LP and tumour markers CEA and CA15.3 would be necessary. Conclusions. The standard staging procedures to detect metastatic disease at breast cancer diagnosis require modification. On the basis of the literature data and our findings, the full staging procedure is appropriate in the second group of patients.

KW - Bone scan

KW - Breast cancer

KW - Chest X-ray

KW - Staging

KW - Ultrasonography

UR - http://www.scopus.com/inward/record.url?scp=0036211751&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036211751&partnerID=8YFLogxK

U2 - 10.1023/A:1014900600815

DO - 10.1023/A:1014900600815

M3 - Article

C2 - 12000220

AN - SCOPUS:0036211751

VL - 72

SP - 53

EP - 60

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 1

ER -