Extension studies for the staging of infiltrating breast cancer. Review of evidence and therapeutic approach at the Instituto Nacional de Cancerología - Colombia
DOI:
https://doi.org/10.35509/01239015.867Keywords:
Breast neoplasms, baseline staging imaging, neoplasm metastasis, neoplasm stagingAbstract
The staging of breast cancer has the objective to determine the extent of the disease, define treatment and prognosis. The American Joint Committee on Cancer (AJCC) has assigned the stage using the size of the tumor (T), the presence of lymph node involvement (N), and the presence or absence of distant metastases (M). With the advent of molecular biology, prognostic information with histological grade, hormone receptor status, and HER2 receptor is integrated with anatomic staging. In the National Institute of Cancerology (INC) the incorporation of TNM brought with it an increase in stage in 14.47% of cases and a decrease in 40.3%; this result was attributed in part to the higher percentage of locally advanced tumors within the institution. By biological subtype, luminal tumors have a higher risk of bone metastases, triple negative tumors to the lung and central nervous system; and HER2 tumors to CNS, liver and lung. Taking this distant involvement into account, the commonly used staging methods are bone scan (BS), chest radiography (CXR), liver ultrasound (UH) and/or computed tomography (CT) scans. In the case of identifying suspicious findings in these tests or if the patient’s clinical condition suggests it, additional studies such as CT or magnetic resonance imaging (MRI) are performed. Changes in the clinical staging and biology of breast cancer motivated the Breast and Clinical Oncology Functional Unit of the National Cancer Institute to review the available scientific evidence to recommend the relevance of extension studies.
Author Biographies
Ana Pedroza-Durán, Especialista en entrenamiento en Mastología, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
1. Especialista en entrenamiento en Mastología, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Daniel González-Hurtado, Especialista en entrenamiento Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
2. Especialista en entrenamiento Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
María Quintero-Ortiz, Especialista en entrenamiento en Mastología, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia
1. Especialista en entrenamiento en Mastología, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Luis Guzmán-Abi-Saab, Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
3. Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Ximena Briceño-Morales, Especialista en entrenamiento en Mastología, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
1. Especialista en entrenamiento en Mastología, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Jesús Oswaldo Sánchez-Castillo, Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
4. Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Ricardo Brugés-Maya, Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
4. Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Fernando Contreras- Mejía, Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
4. Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Carlos Lehmann-Mosquera, Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
3. Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Mauricio García-Mora, Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
3. Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Javier Ángel-Aristizábal, Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
3. Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Iván Mariño-Lozano, Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
3. Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Eduardo Rojas, Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
4. Unidad de Oncología Clínica, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Carlos Duarte-Torres, Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
3. Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
Sandra E. Diaz-Casas, Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
3. Unidad Funcional de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
References
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49. https://doi.org/10.3322/caac.21660
Giuliano AE, Connolly JL, Edge SB, Mittendorf EA, Rugo HS, Solin LJ, et al. Breast cancer-major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017;67(4):290–303. https://doi.org/10.3322/caac.21393
Weiss A, Chavez-MacGregor M, Lichtensztajn DY, Yi M, Tadros A, Hortobagyi GN, et al. Validation study of the American joint committee on cancer eighth edition prognostic stage compared with the anatomic stage in breast cancer. JAMA Oncol. 2018;4(2):203–9. https://doi.org/10.1001/jamaoncol.2017.4298
Cervera-Bonilla S, Rodríguez-Ossa P, Vallejo-Ortega M, Osorio-Ruiz A, Mendoza-Diaz S, Orozco-Ospino M, et al. Evaluation of the AJCC eighth-edition prognostic staging system for breast cancer in a Latin American cohort. Ann Surg Oncol. 2021; 28(11):6014–21. https://doi.org/10.1245/s10434-021-09907-x
Díaz-Casas SE, Briceño-Morales X, Puerto-Horta LJ, Lehmann-Mosquera C, Orozco-Ospino MC, Guzmán-AbiSaab LH, et al. Factors associated with time to progression and overall survival in patients with de novo metastatic breast cancer: A Colombian cohort. The Oncologist. 2022;27(2):e142–50. https://doi.org/10.1093/oncolo/oyab023
Ravaioli A, Pasini G, Polselli A, Papi M, Tassinari D, Arcangeli V, et al. Staging of breast cancer: New recommended standard procedure. Breast Cancer Res Treat. 2002;72(1):53–60. https://doi.org/10.1023/a:1014900600815
Puglisi F, Follador A, Minisini AM, Cardellino GG, Russo S, Andreetta C, et al. Baseline staging tests after a new diagnosis of breast cancer: Further evidence of their limited indications. Ann Oncol. 2005;16(2):263–6. https://doi.org/10.1093/annonc/mdi063
Myers RE, Johnston M, Pritchard K, Levine M, Oliver T, Crump RM, et al. Baseline staging tests in primary breast cancer: A practice guideline. Cmaj. 2001;164(10):1439–44. PMID: 11387916.
Louie RJ, Tonneson JE, Gowarty M, Goodney PP, Barth RJ, Rosenkranz KM. Complete blood counts, liver function tests, and chest x-rays as routine screening in early-stage breast cancer: value added or just cost? Breast Cancer Res Treat. 2015;154(1):99–103. https://doi.org/10.1007/s10549-015-3593-y
Gradishar WJ, Anderson BO, Abraham J, Aft R, Agnese D, Allison KH, et al. NCCN Guidelines (Version 5.2020): Invasive breast cancer. 2020;67. https://doi.org/10.6004/jnccn.2020.0016
Brothers JM, Kidwell KM, Brown RKJ, Henry NL. Incidental radiologic findings at breast cancer diagnosis and likelihood of disease recurrence. Breast Cancer Res Treat. 2016;155(2):395–403. https://doi.org/10.1007/s10549-016-3687-1
Tanaka S, Sato N, Fujioka H, Takahashi Y, Kimura K, Iwamoto M, et al. Use of contrast-enhanced computed tomography in clinical staging of asymptomatic breast cancer patients to detect asymptomatic distant metastases. Oncol Lett. 2012;3(4):772–6. https://doi.org/10.3892/ol.2012.594
Kumar R, Chauhan A, Zhuang H, Chandra P, Schnall M, Alavi A. Clinicopathologic factors associated with false negative FDG-PET in primary breast cancer. Breast Cancer Res Treat. 2006;98(3):267–74. https://doi.org/10.1007/s10549-006-9159-2
Arnaout A, Varela NP, Allarakhia M, Grimard L, Hey A, Lau J, et al. Baseline staging imaging for distant metastasis in women with stages I, II, and III breast cancer. Curr Oncol. 2020;27(2):e123–45. https://doi.org/10.3747/co.27.6147
Schnipper LE, Smith TJ, Raghavan D, Blayney DW, Ganz PA, Mulvey TM, et al. American Society of Clinical Oncology identifies five key opportunities to improve care and reduce costs: The top five list for oncology. J Clin Oncol. 2012;30(14):1715–24. https://doi.org/10.1200/jco.2012.42.8375
How to Cite
Downloads
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Revista Colombiana de Cancerología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Todos los derechos reservados.
