scholarly journals Physical Test for Distant Metastases in Patients with Breast Cancer

1980 ◽  
Vol 73 (9) ◽  
pp. 617-623 ◽  
Author(s):  
R C Coombes ◽  
T J Powles ◽  
M Abbott ◽  
L De Rivas ◽  
H T Ford ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Liver Metastases ◽  
Bone Scan ◽  
Skeletal Metastases ◽  
Entire Group ◽  
Physical Test ◽  
X Ray ◽  
Liver Ultrasound ◽  
Chest X Ray

Of 312 patients presenting with breast cancer to a single clinic, 297 were screened for metastases in skin and nodes, bone, marrow, liver and lungs, using standard clinical, radiological scanning and cytological techniques. Thirty-four patients were found to have overt metastatic disease using these tests. Metastases were demonstrable on chest X-ray in 6.1% of the entire group of patients, on the bone scan in 4.2%, liver scan in 1.5%, liver ultrasound in 1.2% and in the bone marrow in only a single patient; 3.8% had contralateral or supraclavicular lymph node metastases or skin metastases. Twenty-eight of these 34 patients (82%) with overt metastases would have been classed as metastatic had only chest X-ray and clinical examination been carried out. A survey was then carried out to determine when tests for bone and liver metastases became abnormal. Bone scan and skeletal survey results were reviewed in 58 patients, 22 of whom had developed skeletal metastases and all of whom had regular skeletal scintigraphy carried out. Sixteen of 20 (80%) scans carried out within six months of the development of skeletal deposits were abnormal compared with 4 of 19 (21%) scans at the same follow-up time in those who failed to develop metastases, but few patients showed definite evidence of bone metastases on scanning prior to radiological metastases. Fifty-one patients who were found to have liver metastases at post-mortem were reviewed and most showed progressively rising alkaline phosphatase before death but only 11 of 57 (19.2%) and 14 of 50 (28%) had positive liver scintiscans and liver ultrasound examinations respectively from 3–12 months before death.

Baseline diagnostic imaging in early breast cancer—Five-year analysis of a large cohort

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17059-17059
Author(s):  
P. G. Morris ◽  
J. Gray ◽  
C. O' Rafferty ◽  
M. O' Connor ◽  
M. J. Kennedy
Keyword(s):  
Breast Cancer ◽  
Diagnostic Imaging ◽  
Early Breast Cancer ◽  
Metastatic Disease ◽  
Bone Scan ◽  
Bone Pain ◽  
Skeletal Metastases ◽  
Blood Tests ◽  
Liver Ultrasound ◽  
Bone Scans

17059 Background: Many patients with newly diagnosed breast cancer undergo multiple investigations as part of baseline staging, although the evidence base for this is poor. To assess the use of baseline diagnostic imaging and its benefit a review of practice was carried out. Methods: A retrospective review of all patients diagnosed with breast cancer in St James's Hospital in Dublin, Ireland over a five-year period was carried out. Baseline demographics and the appropriateness of baseline diagnostic imaging were assessed. Results: Between 01/01/2001 and 12/31/2005 781 patients were diagnosed with breast cancer in St James's Hospital, of whom 776 were women and 5 were men, with a mean age of 56.7 years. At diagnosis 266 patients (34%) underwent a bone scan, which showed evidence of skeletal metastases in 42 (15.8%). Of the patients with positive bone scans 26 (61.9%) were symptomatic with bone pain, and 16 (38.1%) were not. In the 16 patients without bone pain a diagnostic workup for metastatic disease was undertaken in 5 patients because of clinical findings, in 4 patients because of abnormal liver blood tests and in 5 patients because of radiological findings. Only two patients out of 266 who underwent a bone scan were found to have an incidental finding of metastatic bone disease, of whom one had a bone scan as part of a clinical trial. At diagnosis 261 patients (33.4%) underwent a liver ultrasound, which showed evidence of metastases in 23 (8.8%). Of these, 19 patients had abnormal liver blood tests. Four patients had metastatic disease on liver ultrasound with normal liver blood tests and of these, one patient had a malignant pleural effusion and one patient had inflammatory breast cancer and was considered high risk for metastatic disease. Only two patients out of 261 who underwent a liver ultrasound had incidental findings of liver metastases. Conclusions: Over a five-year period, occult metastases were discovered in only two patients on bone scans and in two patients on liver ultrasounds. The routine use of these imaging modalities to detect metastases in early breast cancer is not justifiable. No significant financial relationships to disclose.

scholarly journals What is the Utility of Routine Complete Blood Count, Liver Function Tests, and Chest X-ray in the Evaluation of Patients with Clinically Node-Negative Breast Cancer?

2019 ◽  
Vol 85 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Ameliay Merrill ◽  
Mary M. Garland ◽  
Marissa Howard-Mcnatt ◽  
Mena Isnassuos ◽  
Kathleen C. Perry ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Blood Count ◽  
Complete Blood Count ◽  
Liver Function Tests ◽  
Screening Tests ◽  
Occult Metastasis ◽  
Preoperative Screening ◽  
Node Negative ◽  
X Ray ◽  
Chest X Ray

National Comprehensive Cancer Network guidelines suggest a selective workup of early-stage breast cancer with complete blood count (CBC) and liver function tests (LFTs) and no longer recommend chest X-ray (CXR) to screen for occult metastasis. We evaluated the utility of routine preoperative screening tests in patients with clinically node-negative (cN0) breast cancer. We identified 1611 patients with cN0 breast cancer treated at our institution between October 1998 and December 2015; 94.4 per cent of the patients underwent at least one preoperative screening test: 90.8 per cent CBC, 89.4 per cent LFTs, and 63.6 per cent CXR. Thirty-six per cent of CBCs, 13.1 per cent of LFTs, and 6.7 per cent of CXRs were abnormal. Abnormalities led to 17 CTscans, and one found an occult metastasis. Eleven patients (0.7%) were diagnosed with metastatic disease post-operatively, but only half had abnormal preoperative screening tests. Positive predictive values of preoperative CBC, LFTs, and CXR for occult metastasis are 1.3 per cent, 1.1 per cent, and 1.5 per cent, respectively. Preoperative screening in cN0 breast cancer is of low yield. Even when abnormalities are found, metastasis is present in less than 1 per cent of patients, and a normal study does not rule out metastasis. Routine preoperative determination is not warranted, and staging studies should be limited to patients with signs or symptoms.

Bone Scan and Liver Ultrasound Scan in the Preoperative Staging for Primary Breast Cancer

2006 ◽  
Vol 12 (6) ◽  
pp. 544-548 ◽  
Author(s):  
Abdul R. Kasem ◽  
Anil Desai ◽  
Simon Daniell ◽  
Prakash Sinha
Keyword(s):  
Breast Cancer ◽  
Primary Breast Cancer ◽  
Bone Scan ◽  
Preoperative Staging ◽  
Ultrasound Scan ◽  
Liver Ultrasound

scholarly journals Juxtacortical Clavicular Chondrosarcoma: Diagnostic Dilemmas: Case Report and Review of Literature

2013 ◽  
Vol 7 ◽  
pp. CMO.S10542 ◽  
Author(s):  
E.I. Efremidou ◽  
A. Oikonomou ◽  
E. Pavlidou ◽  
G. Drosos ◽  
A. Koutsopoulos ◽  
...  
Keyword(s):  
Bone Scan ◽  
Three Dimensional ◽  
Accurate Diagnosis ◽  
Review Of Literature ◽  
Resonance Imaging ◽  
X Ray ◽  
Cartilaginous Tumor ◽  
Accurate Preoperative Diagnosis ◽  
Chest X Ray ◽  
Magnetic Resonance Imaging Mri

Juxtacortical chondrosarcoma is a rare primary malignant cartilaginous tumor accounting for 0.2% of all bone tumors. Wide surgical resection is the treatment of choice for juxtacortical chondrosarcomas. Accurate preoperative diagnosis is important in ensuring appropriate management, staging, and treatment of the patient. A combination of radiographs, three-dimensional imaging with computerized tomography (CT) scan and magnetic resonance imaging (MRI) can typically allow accurate diagnosis of juxtacortical chondrosarcomas. Bone scan and chest x-ray or CT chest scans are indicated for appropriate staging of the patient. Pet scan, ultrasound, bone scan, etc. are not typically needed for the diagnosis. Certainly, pulmonary imaging and bone scan are required for staging and could be commented upon.

scholarly journals Characteristics of Chest X-Ray in Patients with Cancer at the Dharmais Cancer Hospital Emergency Room during the COVID-19 Pandemic

2021 ◽  
Vol 15 (4) ◽  
pp. 195
Author(s):  
Bima Taruna Sakti ◽  
Rosalina Rosalina ◽  
Jaka Pradipta
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Pleural Effusion ◽  
Pleural Effusions ◽  
Hospital Emergency ◽  
X Ray ◽  
Patients With Cancer ◽  
Cancer Hospital ◽  
Hospital Emergency Room ◽  
Chest X Ray

Background: Conventional chest X-ray (chest X-ray) in Dharmais Cancer Hospital emergency room (ER) is still the primary modality to diagnose patients with cancer with dyspnoea complaints. Chest X-ray was also carried out to screen inpatients at the Dharmais Cancer Hospital ER at the beginning of the COVID-19 pandemic in Indonesia. It was essential because patients in the Dharmais Cancer Hospital ER were patients with cancer, with low immunity and a high risk of being exposed to various infections. Thus, the purpose of this study was to determine the characteristics of chest X-rays in patients with cancer at the Dharmais Cancer Hospital ER during the COVID-19 pandemic in February-May 2020. Methods: This was a descriptive study. The population involved was all patients at the Dharmais Cancer Hospital ER who received chest X-ray support, with the inclusion criteria for diagnosing lung cancer, breast cancer, cervical cancer, colorectal cancer, and blood cancer (Leukemia) from February to May 2020. Data analysis employed univariate analysis by utilizing tables and graphs in presenting the data.Results: 289 samples met the research criteria. The highest visits were patients with breast cancer (41.2%). The most common thoracic images were pleural effusion (34.3%), followed by bronchopneumonia (31.1%), normal lung (16.6%), lung mass (7.6%), pneumonia (5.2%), and others (5.2%), consisting of atelectasis, bronchitis, fibrosis/chronic pulmonary process, pulmonary emphysema, cardiomegaly, and specific process. Besides, the chest x-ray bronchopneumonia was 31.1% (90 samples), accompanied by pleural effusion of 44.4%. From the chest X-ray, pleural effusions were 34.3% (99 samples), with lung cancer being the most common with pleural effusions (48.4%).Conclusions: More than 80% of chest x-ray performed in the ER are abnormal. Also, breast cancer is the highest in the Dharmais Cancer Hospital ER cases, with the highest chest x-ray of pleural effusion.

Tc-99m MDP Bone Scan Evaluation in Breast Cancer: A Study on 425 Patients

2018 ◽  
Vol 30 (2) ◽  
pp. 49-52
Author(s):  
MM Arif Hosen ◽  
Nasrin Begum ◽  
Mosharrof Hossain ◽  
Parvez Ahmed ◽  
Pupree Mutsuddy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Bone Scan ◽  
Metastatic Breast ◽  
Cost Effective ◽  
Skeletal Metastasis ◽  
Developed Countries ◽  
Skeletal Metastases ◽  
Breast Cancer Patients ◽  
Phase Images

Breast cancer is the most frequent female cancer, especially in 'developed' countries. 30-85% of metastatic breast cancer patients will develop bone metastases during the course of the disease. The objective of this study was to evaluate the skeletal metastases in breast cancer patients by using Tc-99m MDP bone scan. A retrospective study was conducted on 425 consecutive female breast carcinoma patients referred for bone scan to Institute of Nuclear Medicine and Allied Sciences, Rajshahi from January 2015 to November 2017. Bone scan was performed by an intravenous bolus injection of 20 mCi Tc99m-MDP (technetium 99m methylenediphosphonate). Bone phase images were taken at three hours after injection of the radiotracer. Out of 425 patients, 290 patients (68.24%) had either normal bone scan or negative for skeletal secondaries and 135 patients (31.76%) were positive for skeletal metastases.Out of 135 positive bone scans 114 (84.44%) patients had multiple sites (two or more) and 21 (15.56%) patients had solitary site of bony involvement. Highest number of skeletal metastases was noted in thoraco-lumbar spine (81.48%). Other sites of metastases were in cervical spine (22.96%), pelvic bones (54.81%), ribs (40.74%), sternum (16.30%), scapula (19.26%), upper extremities (28.15%), lower extremities (36.30%), skull bone (12.60%) and clavicle (13.33%). Tc-99m MDP bone scan is very cost effective in comparison to other imaging modalities (CT, MRI, and PET) and play a major role in early detection of skeletal metastasis in breast cancer patients.Medicine Today 2018 Vol.30(2): 49-52

Bone Marrow Biopsy and Bone Scan To Detect Skeletal Metastases

2001 ◽  
Vol 26 (8) ◽  
pp. 677-679 ◽  
Author(s):  
IMRAN MIRZA ◽  
BEATRIZ CUELLO ◽  
ANIL RAMACHANDRAN ◽  
WILLIAM JOHNS
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Bone Scan ◽  
Skeletal Metastases
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