Quality Care Symposium: Prevalence of Unnecessary Scans for Early-Stage Breast Cancer
Posted: Friday, October 12, 2018
A study recently presented at the 2018 American Society of Clinical Oncology (ASCO) Quality Care Symposium (Abstract 52) in Phoenix found that 19% of patients with early-stage breast cancer underwent routine scans that did not prove necessary for their treatment. Ana I. Velazquez Manana, MD, of Mount Sinai Beth Israel Hospital, and colleagues sought to determine adherence rates to the 2012 ASCO Choosing Wisely Initiative, which recommends against routine scanning in patients newly diagnosed with early-stage breast cancer.
“Routine imaging resulted in increased radiation exposure and additional cost of $4,480/patient,” reported the investigators. “The presence of T2 tumor, positive lymph node, TN disease, and young age were associated with increased staging scan. Further educational efforts are needed to avoid unnecessary scans in patients with early-stage [breast cancer].”
A total of 733 patients with breast cancer were included in the study. The median patient age was 58 years. Routine imaging had been performed for 139 patients in the group, with a mean scan number of 1.53. Of those 139 participants, 59 (42%) underwent at least 1 additional scan in the year following diagnosis.
Positron-emission tomography/computed tomography (CT) scans were the most frequently performed, followed by CT scans alone. Imaging was ordered by a medical oncologist in 52% of cases and by a surgical oncologist in 44.6% of cases. Routine imaging did not identify any cases of metastatic disease. In 43% of cases, false-positive findings were reported, and 8% of cases had incidental findings reported.
