title: Value of routine staging imaging studies for patients with stage III breast cancer.
abstract: OBJECTIVE
  Routine staging imaging studies (RSIS) are optional in stage III breast cancer (BC). The impact of RSIS on treatment decisions and patient outcomes has not been extensively studied. The goal of this study was to determine whether RSIS in stage III BC affected treatment or patient outcomes.
  
  
  METHODS
  Stage III BC patients from 2000 to 2010 were retrospectively identified. RSIS results and treatment plan in response to RSIS results were recorded. Univariate and multivariate Cox proportional hazards regression models with time-dependent covariates were used to assess associations between RSIS use and recurrence-free survival (RFS).
  
  
  RESULTS
  Of 420 patients, 362 (86.2%) received RSIS. RSIS were negative in 264 (72.9%), indeterminate in 77 (18.3%), and positive in 21 patients (5.0%) for metastatic disease. Treatment was altered in 21 (5.8%) patients based on RSIS results (20 with metastatic disease, 1 with indeterminate disease). There was no difference in RFS with RSIS use on multivariate analysis (hazard ratio 1.3; 95% confidence interval 0.73-2.5, P = 0.32).
  
  
  CONCLUSIONS
  Most stage III BC patients underwent RSIS, but RSIS results infrequently affected treatment decisions. There was no significant difference in RFS with RSIS use. RSIS to identify metastatic disease for stage III BC has limited value. J. Surg. Oncol. 2016;114:917-921. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Jane Anne Nohl Division of Hematology, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California.
authors.forename: Caroline I
authors.initials: CI
authors.lastname: Piatek
authors.affiliation: Department of Biostatistics, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California.
authors.forename: Lingyun
authors.initials: L
authors.lastname: Ji
authors.affiliation: University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California.
authors.forename: Chandan
authors.initials: C
authors.lastname: Kaur
authors.affiliation: Department of Medical Oncology, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California.
authors.forename: Christy A
authors.initials: CA
authors.lastname: Russell
authors.affiliation: Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Debu
authors.initials: D
authors.lastname: Tripathy
authors.affiliation: University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California.
authors.forename: Terry
authors.initials: T
authors.lastname: Church
authors.affiliation: Department of Biostatistics, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California.
authors.forename: Richard
authors.initials: R
authors.lastname: Sposto
authors.affiliation: Department of Surgery, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California.
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Sener
authors.affiliation: Department of Hematology/Oncology, Louisiana State University, New Orleans, Louisiana.
authors.forename: Agustin A
authors.initials: AA
authors.lastname: Garcia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D000066491:Clinical Decision-Making; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: breast neoplasms; neoplasm staging; treatment outcome