Screening for metastasis in primary breast cancer patients having four or more axillary lymph node involvement: is it really necessary?
Küçük Resim Yok
Tarih
2010
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Imprimatur Publications
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Purpose: To evaluate the necessity and direct cost effectiveness of screening and staging procedures in breast cancer patients having >= 4 positive axillary lymph nodes and to identity further possible biopathological risk factors associated with increased risk of metastasis. Methods: We reviewed the demographic and clinicopathological data from the medical records of 1897 newly diagnosed breast cancer patients. Patients having >= 4 positive axillary lymph nodes after primary surgery for breast cancer and who had staging examinations for metastasis were eligible. The impact of staging procedures (thoracoabdominal CT, bone scan etc.) for detecting metastasis, decision of adjuvant treatment and direct costs were analyzed in 329 patients with operable breast cancer Results: Thirty-five (10.6%) patients were found with metastasis at diagnosis. Seven (20.0%) among them had multiple metastases. Eighteen (51.4%) had lung, 17(48.6%) bone, and 7 (20.0%) liver metastasis. Twenty-one (60.0%) patients needed further radiological investigation for metastasis confirmation. Treatment decision was changed in 27 (77.1%) patients. No statistically significant risk factor was identified among the metastatic patients by means of conventional demographic and biopathological parameters. The cost of screening was lower when compared to the cost of treatment without any screening procedure. Conclusion: Since the conventional clinicopathological data seems not sufficient to define the risk of developing metastasis in breast cancer patients with >= 4 axillary lymph node involvement, all of them should undergo full staging examinations until new parameters based on genomic level are defined. Staging procedures need modification for high risk breast cancer patients.
Açıklama
Anahtar Kelimeler
axillary lymph node involvement, biopathological parameters, breast cancer, costs, metastasis, staging
Kaynak
Journal of Buon
WoS Q Değeri
N/A
Scopus Q Değeri
Cilt
15
Sayı
3
