178P Imaging for distant metastasis in local and locally advanced breast cancer: Practice and detection rates

Abstract

Breast cancer is the most common cancer among women, with most cases being diagnosed at an early stage of the disease, with 5% being metastatic at diagnosis. Despite this, besides physical examination, other imaging tests at diagnosis are not routinely recommended, unless high tumour burden, aggressive biology or when symptoms suggestive of metastases are present. Retrospective and comprehensive study including breast cancer patients that were diagnosed and evaluated at an oncology department during the year of 2019, at a district hospital in Portugal. Data was obtained from patients’ clinical process and analyzed by SPSSv25. 156 patients were included with a median of 64 years and the majority were females n=152. Regarding tumor histology, the majority was ductal carcinoma (83%), with most having a grade 2 tumor (57%). Regarding breast cancer subtypes, the majority (86%) was a luminal-like tumor. The ECOG Performance Status at the beginning of treatment was evaluated with 87% having grade 0-1. Diagnostic work-up exams were performed in 117 patients and they included computed tomography of thorax abdomen and pelvis, bone scintigraphy, ultrasounds, among others. All patients with initial stages were asymptomatic and of the patients with abnormal findings, 7 were treated. Regarding treatment, 126 patients were submitted to endocrine therapy and 92 systemic therapy: 5 as palliative, 54 as neoadjuvant and 33 as adjuvant setting.Table: 178PAsked exams according to initial clinical stageStagePatients who did image exams (n)Total of image exams (n)Patients with abnormal findings (n)I (n=64)43880IIA (n=37)30890IIB (n=20)18513IIIA (n=10)7193IIIB (n=9)9244IIIC (n=2)240 Open table in a new tab Despite the evidence regarding the right work up and diagnosis, there are still some patients with early breast cancer that undergo excessive image exams. It is important to work with coordination and in a multidisciplinary team in order to create adequate protocols, to accurately stage and stratify breast cancer patients. As shown with our results, in more initial stages, the exams do not detect metastatic disease and can contribute to the delay of treatments, to an increase of health costs and also as a source of distress to patients.