title: The use of cerebral computer assisted tomography as a staging investigation of patients with carcinoma of the breast and malignant melanoma.
abstract: These results indicate that computer assisted tomography of the brain, even when contrast medium enhanced, does not contribute to the detection of occult intracerebral metastases in patients with primary carcinoma of the breast and of malignant melanoma, even if the disease is locally advanced. The number of patients with malignant melanoma is still small, and this part of the study is continuing. However, we have discontinued the use of computer assisted tomography as a staging investigation for patients with carcinoma of the breast. Although the yield of positive scans in those 31 patients with metastatic, or locally recurrent, disease, but no neurologic symptoms, is subsequently found to be 13 per cent at follow-up study, this would not appear to be a profitable investigation in the absence of effective therapy. In our series of patients with neurologic symptoms, abnormal and positive scans were obtained in five of 18 patients. However, even in such patients, a negative computer assisted tomography did not exclude intracerebral metastatic disease. There is no place for routine computer assisted tomography as a staging investigation for patients with early carcinoma of the breast or with malignant melanoma. Its use should be restricted to those patients who have symptoms of cerebral disease.
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D008545:Melanoma / Q000473:pathology; D009367:Neoplasm Staging; D012878:Skin Neoplasms / Q000473:pathology; D014057:Tomography, X-Ray Computed