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The clinical use of staging bone scan in patients with breast carcinoma: reevaluation by the 2003 American Joint Committee on Cancer staging system

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Authors
Lee, Jeong Eon; Park, Sung-Shin; Han, Wonshik; Kim, Seok Won; Shin, Hyuk Jai; Choe, Kuk Jin; Oh, Seung Keun; Youn, Yeo-Kyu; Noh, Dong-Young; Kim, Sung-Won
Issue Date
2005-06-22
Publisher
John Wiley & Sons
Citation
Cancer. 2005 Aug 1;104(3):499-503
Keywords
AdultAgedAged, 80 and overBone Neoplasms/*radionuclide imaging/secondaryBone and Bones/*radionuclide imagingBreast Neoplasms/*pathology/*radionuclide imaging/therapyFemaleHumansMiddle AgedNeoplasm Invasiveness/pathologyNeoplasm Staging/*standardsPredictive Value of TestsProspective StudiesRadiopharmaceuticals/diagnostic useRisk FactorsSurvival Rate
Abstract
BACKGROUND: Using the new 2003 American Joint Committee on Cancer (AJCC) staging system, the authors evaluated the usefulness of the staging bone scan in patients with primary breast carcinoma. METHODS: The authors examined 1939 patients with primary breast carcinoma for staging bone scan who were treated at a single institution. Pathologic stage was assigned retrospectively according to the 1988 and the 2003 AJCC staging systems. RESULTS: Bone metastasis rates were 0.7% (4 of 586) for patients with Stage I disease, 0.7% (5 of 699) for patients with Stage IIA disease, 2.1% (10 of 479) for patients with Stage IIB disease, 4.5% (7 of 154) for patients with Stage IIIA disease, and 10.5% (2 of 19) for patients with Stage IIIB disease according to the 1988 AJCC staging system. The authors found a significant difference in the bone metastasis rate between patients with Stages IIA and IIB disease in the 1988 staging system (P = 0.039). Reevaluating the patients by the 2003 system resulted in significant upstaging, especially for patients with Stage II/III disease. According to the 2003 staging system, bone metastasis rates were 0.7% (4 of 586) for patients with Stage I disease, 0.6% (4 of 648) for patients with Stage IIA disease, 0.6% (2 of 310) for patients with Stage IIB disease, 4.0% (9 of 225) for patients with Stage IIIA disease, 16.7% (2 of 12) for patients with Stage IIIB disease, and 4.4% (7 of 158) for patients with Stage IIIC disease. It was noteworthy that there was a significant difference between Stages IIB and IIIA in the 2003 staging system (P = 0.010). CONCLUSIONS: Stage reclassification using the new AJCC staging system resulted in upstaging of high-risk patients, as well as a significant decrease in the bone metastasis rate in patients with Stage IIB breast carcinoma. Considering the cost-effectiveness of staging bone scan, the data suggested that it was of little value for patients with Stage I and II breast carcinoma, but was highly recommended for patients with worse than Stage III disease by the new 2003 staging system.
ISSN
0008-543X (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15968691

http://hdl.handle.net/10371/15800
DOI
https://doi.org/10.1002/cncr.21200
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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