The value of metastatic screening in early primary breast cancer

Up to 25 per cent of patients presenting with "early" breast cancer subsequ ently develop distant metastases indicating that this group must have occul t disseminated disease when initially evaluated, Routine pre-operative haem atological and radiological investigation is recommended in order to identi fy these patients and alter their management accordingly. The aim of this s tudy was to examine the outcome of a pre-operative metastatic screening pro gramme in patients presenting with early breast cancer. Eighty-two patients underwent surgery for stage I-II breast cancer over a 5 yr period from 199 0-1995, Before surgery all patients underwent screening tests for metastati c disease. These included a full blood count, liver function tests, chest x -ray, skeletal survey and abdominal ultrasound, Of the 82 patients, metasta tic screening significantly altered management in only 1 patient who was fo und to have asymptomatic lymphangitis carcinomatosa on chest x-ray, The res ults of this study suggest that the number of patients restaged by screenin g for metastatic breast cancer may be small and questions the necessity for its routine use in the management of early primary breast cancer.