Usefulness of staging chest-CT in patients with operable breast cancer

• Published in: PloS one 2021-02, Vol.16 (2), p.e0246563-e0246563
• Main Authors: Hong, Jung Hee, Goo, Jin Mo, Moon, Hyeong-Gon, Chang, Jung Min, Lee, Jong Hyuk, Park, Chang Min
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Breast cancer; Cancer; Cancer therapies; Care and treatment; Chest; Computed tomography; Data analysis; Diagnosis; Diagnostic systems; Editing; Electronic health records; Electronic mail; Electronic medical records; Epidermal growth factor; ErbB-2 protein; Estrogen receptors; Estrogens; Growth factors; Hospitals; Mammography; Medical diagnosis; Medical imaging; Medical research; Medical schools; Medicine; Medicine and Health Sciences; Metastases; Metastasis; Methodology; Patients; Progesterone; Radiology; Receptors; Research and Analysis Methods; Surgery; Survival; Visualization
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0246563

The aim of this study was to investigate the usefulness of staging chest-CT in terms of diagnostic yield and false-referral rate in patients with operable breast cancer. This study was approved by the institutional review border. In this retrospective study, we reviewed patients who underwent staging chest-CT between January 2014 and June 2016. Reference standard was defined as a combination of pathology and radiologic tumor changes in accordance with primary tumor or metastatic lesions and stability during the 12-month follow-up period. We calculated diagnostic yield and false-referral rates stratified by pathologic stage. The important ancillary findings of staging chest-CT were also recorded. A total of 1,342 patients were included in this study. Of these, four patients (0.3%; 4/1342) had true pulmonary metastasis. Diagnostic yields of stage I, II, III disease were 0.0% (0/521), 0.3% (2/693), and 1.6% (2/128), respectively. The overall false-referral rate was 4.6% (62/1342); false-referral rates of stage I, II, and III disease were 5.0% (26/521), 3.8% (26/693), and 7.8% (10/128), respectively. No occult thoracic metastasis occurred within 12 months of staging chest-CT. Nineteen patients showed significant ancillary findings besides lung metastasis, including primary lung cancer (n = 9). The overall diagnostic yield of ancillary findings was 1.7% (23 of 1342). The incidence of pulmonary metastasis was near zero for pathologic stages I/II and slightly higher (although still low; 1.6%). for stage III. Considering its low diagnostic yield and substantial false-referral rates, staging chest-CT might not be useful in patients with operable breast cancer.