Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Comprehensive audit of baseline investigations and subsequent management of patients with breast cancer at Peninsula Health (#344)

Sruti Pillai 1 , Vi Luong 1 , Richard Pham 1 , Babak Tamjid 1
  1. Department of Medical Oncology, Peninsula Health, Frankston, VIC, Australia

Background:

Appropriate baseline staging in newly diagnosed invasive breast cancer is essential in determining patient management. NCCN guidelines recommend staging with CT and bone scan in T4 or node positive locally advanced breast cancer, in the absence of symptomatic metastatic disease. This is also supported by multiple case studies, which report increased incidence of metastases found on baseline staging in Stage III disease (AJCC 8th edition), with limited value in Stage I and II breast cancer 1,2,3.

Aim: 

The main aim of this project is to explore the rate of diagnosis of metastases in patients with clinical stage I-III breast cancer. This project will also assess the current practice within Peninsula Health, compared with national and international guidelines. Demographic and subsequent management data will also be collected.

Methods:

We are collecting retrospective data of 630 patients who have been discussed in breast multidisciplinary meetings at Peninsula Health with newly diagnosed invasive breast cancer from September 2014 to March 2019. This includes tumour characteristics, pathological and clinical staging, number and modality of imaging, rate of detection of metastatic disease, baseline echocardiography data, additional scans conducted and subsequent changes in management that occurred due to baseline scan results.

Results:

This is an ongoing project and the outcome will be available for presentation in COSA ASM 2019.

Conclusions:

The aim of this project is to determine the rate of discovering metastases in patients with newly diagnosed invasive breast cancer according to initial staging. The other aim of this study is to compare the current practice at Peninsula Health with universally accepted guidelines and make evidence-based recommendations. These recommendations may result in a reduced number of baseline investigations, which will decrease the burden on hospital and community resources.

  1. Myers, Robert E., et al. "Baseline staging tests in primary breast cancer: a practice guideline." Cmaj164.10 (2001): 1439-1444.
  2. Puglisi, F., et al. "Baseline staging tests after a new diagnosis of breast cancer: further evidence of their limited indications." Annals of Oncology 16.2 (2005): 263-266.
  3. Ravaioli, Alberto, et al. "Staging of breast cancer: new recommended standard procedure." Breast cancer research and treatment 72.1 (2002): 53-60.