ACR Appropriateness Criteria®Stage I Breast Carcinoma.
Stage I breast carcinoma is classified when an invasive breast carcinoma is ≤2 cm in diameter (T1), with no regional (axillary) lymph node metastases (N0) and no distant metastases (M0). The most common sites for metastases from breast cancer are the skeleton, lung, liver, and brain. In general, women and health care professionals prefer intensive screening and surveillance after a diagnosis of breast cancer. Screening protocols include conventional imaging such as chest radiography, bone scan, ultrasound of the liver, and MRI of brain. It is uncertain whether PET/CT will serve as a replacement for current imaging technologies. However, there are no survival or quality-of-life differences for women who undergo intensive screening and surveillance after a diagnosis of stage I breast carcinoma compared with those who do not. The ACR Appropriateness Criteria®are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
St Luke's Episcopal Hospital, Houston, Texas. Electronic address: phuynh1@sleh.org.
Phan Tuong
PT
Huynh
Baylor College of Medicine, St Luke's Hospital, Ben Taub General Hospital, Houston, Texas.
Sergy V
SV
Lemeshko
University of Cincinnati, Cincinnati, Ohio.
Mary C
MC
Mahoney
Emory University Hospital, Atlanta, Georgia.
Mary S
MS
Newell
Imagimed, LLC, Rockville, Maryland; American College of Surgeons, Chicago, Illinois.
Lisa
L
Bailey
Invision Sally Jobe, Englewood, Colorado.
Lora D
LD
Barke
Emory University Hospital, Atlanta, Georgia.
Carl
C
D'Orsi
University of Virginia Medical Center, Charlottesville, Virginia.
Jennifer A
JA
Harvey
Memorial Regional Hospital, Hollywood, Florida.
Mary K
MK
Hayes
Rush Breast Imaging Center, Chicago, Illinois.
Peter M
PM
Jokich
University of Cincinnati, Cincinnati, Ohio.
Su-Ju
SJ
Lee
University of Washington, Seattle, Washington.
Constance D
CD
Lehman
Rhode Island Hospital, Providence, Rhode Island.
Martha B
MB
Mainiero
University of Washington, Seattle, Washington; Society of Nuclear Medicine, Reston, Virginia.
David A
DA
Mankoff
Radiology Inc, Mishawaka, Indiana.
Samir B
SB
Patel
Radiology Association of Atlanta, Atlanta, Georgia.
Handel E
HE
Reynolds
Newport Diagnostic Center, Newport Beach, California.
M Linda
ML
Sutherland
University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Bruce G
BG
Haffty
D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D055088:Early Detection of Cancer / Q000592:standards*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008327:Mammography / Q000592:standards*; D008495:Medical Oncology / Q000592:standards; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D011871:Radiology / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018571:Sentinel Surveillance; D014481:United States
Appropriateness criteria; early breast cancer; surveillance protocol