Fast Five Quiz: Are You Prepared to Confront Metastatic Breast Cancer?

Winston W. Tan, MD; Stefania Morganti, MD


December 15, 2022

CT scan of the chest, abdomen, and pelvis is the gold standard for staging and in suspected cases of metastatic relapse. CT scans are also recommended in patients with locally advanced disease, to rule out metastatic spread before surgery or neoadjuvant therapy.

Mammography is not indicated when metastatic disease is suspected in a patient with a prior history of breast cancer, whereas it is recommended for screening and diagnosis of primary breast cancer.

Breast ultrasonography is not routinely used for breast cancer screening and for staging purposes. However, it can provide valuable information about the nature and extent of breast masses, especially in young women. Additionally, ultrasonography is potentially useful for staging of the axilla and for guiding biopsies.

American Cancer Society guidelines and NCCN Clinical Practice Guidelines in Oncology recommend annual breast MRI screening for women at high risk for breast cancer, which includes BRCA mutation carriers and their untested first-degree relatives; women with Li-Fraumeni syndrome and other high-risk predisposition syndromes; women with a history of thoracic radiation therapy between age 10-30 years; and women with > 20% lifetime risk of breast cancer based on risk assessment models.

Breast MRI is rarely indicated in patients with proved metastatic breast cancer.

Learn more about the workup of metastatic breast cancer.


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