10. Staging
For breast cancer patients without symptoms suggestive of metastases at clinical stage 3, the ECIBC's Guidelines Development Group (GDG):
- recommends using conventional staging exams, if positron emission tomography-computed tomography (PET-CT) is not readily available (strong recommendation, moderate certainty of the evidence)
- suggests using positron emission tomography-computed tomography (PET-CT) alone rather than conventional staging exams or the combination of conventional staging exams plus PET-CT (conditional recommendation, low certainty of the evidence)
Stage 3: conventional exams
Issued on: September 2018
Healthcare question
Should conventional staging exams vs. no staging exams be used for patients with clinical stage III breast cancer without symptoms suggestive of metastases?
Recommendation
The ECIBC's Guidelines Development Group (GDG) recommends using conventional staging exams with imaging in women with clinical stage III breast cancer.
Recommendation strength
| Strong recommendation |
| Moderate certainty of the evidence |
Subgroup considerations
The GDG also notes that age and presence of comorbidities of the patient may be a consideration in the decision of whether to conduct staging exams with imaging as this may change the choice of treatment.
Considerations for implementation and policy making
The GDG considered the definition of stage groups according to the American Joint Commission on Cancer TNM Anatomic Stage Groups (8th ed.) listed in the ECIBC glossary.
Monitoring and evaluation
The GDG suggests monitoring that women with clinical stage III breast cancer receive staging exams using imaging.
Research priorities
- The GDG suggests research assessing the cause of false positive cases to minimize the number of false positives and the undue stress that this poses on patients with clinical stage III breast cancer.
- The GDG suggests research on non-ionizing and low-radiation dose alternatives for staging exams using imaging.
Supporting material