title: Distant metastasis detected by routine staging in breast cancer patients participating in the national German screening programme: consequences for clinical practice.
abstract: OBJECTIVE
  To determine frequency of routine radiological staging of breast cancer patients diagnosed in a German Breast Cancer Screening Center from 2007 to 2014, the incidence and consequences of distant metastases detected and the resulting implications for clinical routine.
  
  
  METHODS
  Records of 896 patients with primary breast cancer diagnosed in the Screening Centre and treated in five participating hospitals were analyzed retrospectively. Evaluation included frequency and type of staging procedures and results with respect to distant metastasis and their consequences on clinical management.
  
  
  RESULTS
  894/896 Patients (99.8 %) received staging for distant metastases by bone scintigraphy, chest X-ray and liver sonography and/or CT/MRT diagnostics. Distant metastasis was suggested In 6/894 patients but excluded in 3 by further diagnostics or clinical course. Thus, 3 (0.3 %) were clinically verified to have metastatic disease in bone (n = 2; both pT2) or in bone and lung (n = 1; cT4, cN3).
  
  
  CONCLUSIONS
  Due to the low incidence of verified metastatic disease, the high false positive rate of staging procedures and the unfavorable cost/benefit ratio routine radiological staging should be completely omitted in asymptomatic breast cancer patients diagnosed in a breast cancer screening programme.
authors.affiliation: Universitätsfrauenklinik Essen, Hufelandstr. 55, 45122 Essen, Germany.
authors.forename: Peter
authors.identifier: 0000-0002-4890-3503
authors.initials: P
authors.lastname: Rusch
authors.affiliation: Universitätsfrauenklinik Essen, Hufelandstr. 55, 45122 Essen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Hoffmann
authors.affiliation: Universitätsfrauenklinik Essen, Hufelandstr. 55, 45122 Essen, Germany.
authors.forename: Anna-L
authors.initials: AL
authors.lastname: Stickelmann
authors.affiliation: Evangelisches Krankenhaus Oberhausen, Virchowstr. 20, 46047 Oberhausen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Böhmer
authors.affiliation: Alfried Krupp Krankenhaus, Alfried-Krupp-Straße 21, 45131 Essen, Germany.
authors.forename: Regine
authors.initials: R
authors.lastname: Gätje
authors.affiliation: Diavero Diagnosezentrum Essen, Heidbergweg 22, 45257 Essen, Germany.
authors.forename: Karl G
authors.initials: KG
authors.lastname: Krüger
authors.affiliation: Elisabeth-Krankenhaus Essen, Klara-Kopp-Weg 1, 45138 Essen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Niesert
authors.affiliation: Evangelisches Krankenhaus Mülheim, Wertgasse 30, 45468 Mülheim an der Ruhr, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Schmidt
authors.affiliation: Universitätsfrauenklinik Essen, Hufelandstr. 55, 45122 Essen, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Kimmig
keywords: Breast cancer; Distant metastases; Routine staging; Screening