title: Bone scan and liver ultrasound scan in the preoperative staging for primary breast cancer.
abstract: The aim of the present study was to investigate the value of preoperative staging in primary operable breast cancer. This retrospective study included patients presenting between May 1999 and February 2004 with operable primary breast cancer. Of the 221 patients 189 had normal and 32 suspicious or positive bone scans (BS). Of the 189 patients with normal BS 182 had normal liver ultrasound (US), whereas the remaining seven patients underwent computed tomography scan which was normal in five and two confirmed liver metastases (one with abnormal LFTs). Of the 32 patients with suspicious or positive BS 26 were false positive on further investigations and the remaining six patients were confirmed to have bony metastasis (one abnormal bone profile). BS and liver US truly altered treatment in 3% of patients. False-positive results caused delay, psychological upset, and costly investigations in 14% of cases. Preoperative staging with liver US and BS should be reserved for high-risk patients.
authors.affiliation: Department of Surgery and Radiology, Breast Unit, Princess Royal University Hospital, Farnborough Common, Greater London, United Kingdom. abkasem@doctors.net.uk
authors.forename: Abdul R
authors.initials: AR
authors.lastname: Kasem
authors.forename: Anil
authors.initials: A
authors.lastname: Desai
authors.forename: Simon
authors.initials: S
authors.lastname: Daniell
authors.forename: Prakash
authors.initials: P
authors.lastname: Sinha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D014463:Ultrasonography