285P - What do clinicians do with the results of the systematic staging imaging at the time of breast cancer diagnosis?

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Breast Cancer, Early Stage
Imaging, Diagnosis and Staging
Presenter Anthony Turpin
Authors A. Turpin1, A. Mailliez1, P. Vennin1, J. Bonneterre2
  • 1Breast Cancer, Centre Oscar Lambret, 59000 - Lille/FR
  • 2Centre Oscar Lambret, Université Lille Nord de France, 59000 - Lille/FR

Abstract

Introduction

Asymptomatic distant metastases are often looked for at the time of initial diagnosis of early breast cancer. However, there is no consensus on when to perform it and on the consequences on the treatment.

Patients and methods

125 asymptomatic women receiving systemic neoadjuvant (33 patients (pts)) or adjuvant treatment (92 pts) for breast cancer at the Oscar Lambret Center in 09/2011 were considered. The staging imaging was a PET scan: 59 pts, a CT scan + a bone scan: 61 pts and both: 5 pts. Results for each procedure were considered normal, abnormal but typically benign or potentially malignant. In this case, another imaging technique was carried out to confirm the suspected diagnosis. The patient was considered metastatic if the results of two different procedures were concordant and eventually in case of response to chemotherapy. 1 patient had a biopsy (liver). 22 pts were Stage 1, 58 Stage 2, 44 Stage 3. 1 other patient had an excision of a recurrence on mastectomy scar.

Bone scan + CT scan PET scan Both Total
Pts 61 59 5 125
Potentially malignant lesions 13 8 2 23 (including confirmed malignant)
Malignant lesions 5 2 2 9
Benign lesions 33 15 1 49
Confirmatory Procedures 19 19 2 40

Results

9 pts were considered metastatic (7%): 5 bone, 2 liver, 1 lung and 1 spleen. There was 1 Stage 1, 4 Stage 2, and 4 Stage 3. 3 of the 5 pts in the neoadjuvant setting were operated on (2 after the planned chemotherapy: 1 complete response of lung metastasis and 1 sternal lesion treated by boost and 1 after modified protocol for unique liver lesion which will be treated by Cyberknife®). The 2 others had bone lesions, received modified protocol and did not have surgery. For the pts in the adjuvant setting, 2 received the full treatment (1 continued Trastuzumab beyond the year planned), 1 received modified protocol of chemotherapy then radiotherapy and hormonotherapy and the last one received chemotherapy alone.

Conclusion

In this population of 125 pts selected for (neo) adjuvant chemotherapy, 40 imaging procedures were performed to check the lesions. 9 pts were considered as metastatic and only 5 had had a significant modification of their treatment. A systematic imaging staging in pts selected for adjuvant chemotherapy should not be recommended.

Disclosure

All authors have declared no conflicts of interest.