Fast Five Quiz: Early-Stage Breast Cancer

Maurie Markman, MD


January 14, 2021

As stated in guidelines from the European Society for Medical Oncology (ESMO), in patients planned for (neo)adjuvant systemic treatment either with anthracyclines and/or trastuzumab, evaluation of cardiac function with a cardiac ultrasound or a multigated acquisition (MUGA) scan is essential.

Routine staging evaluations in early-stage breast cancer are aimed at locoregional disease; asymptomatic distant metastases are rare. According to ESMO, radiologic staging and comprehensive laboratory tests are not beneficial for most patients with early-stage disease.

A CT scan of the chest, abdominal imaging (US, CT, or MRI scan), and a bone scan should be considered for patients with:

  • Clinically positive axillary nodes

  • Large tumors (≥ 5 cm)

  • Aggressive biology

  • Clinical signs, symptoms, or laboratory values suggesting the presence of metastases

In patients with small tumors, measuring only the residual tumor in the excision may lead to the cancer being understaged. ESMO recommends that imaging, clinical, and gross findings be correlated with microscopic observation if necessary.

For additional information, refer to the ESMO guidelines.

Learn more details about the workup for early-stage breast cancer.


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