TY - JOUR
T1 - Routine X-ray of the chest is not justified in staging of patients with primary breast cancer
AU - Lind, Katrine
AU - Borhani-Khomani, Kaveh
AU - Okholm, Mette
AU - Bartnikowska, Hanna Eliza
AU - Gjørup, Caroline Asirvatham
N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
PY - 2022/10/12
Y1 - 2022/10/12
N2 - INTRODUCTION: Chest X-rays (CXRs) are performed routinely as part of staging of primary breast cancer patients in most breast units in Denmark. However, several international studies have found exceedingly low detection rates for occult pulmonary metastatic disease among breast cancer patients. Even so, no data have previously been published on Danish patients.METHODS: A retrospective study was conducted of all breast cancer patients undergoing CXRs at the Department of Breast Surgery, Herlev Hospital, from April 2016 to December 2017. The primary outcome was detection of pulmonary metastases on CXRs at the time of the patient's breast cancer diagnosis. The follow-up period was 12 months.RESULTS: A total of 1,014 patients were included in this study. Among these, 11 (1%) had a positive CXR and 1,003 (99%) had a negative CXR. Three (0.3%) patients were diagnosed with lung metastases but had false negative CXRs. The sensitivity was 0%, the specificity was 98.9%, the positive predictive value was 0% and the negative predictive value was 99.6%.CONCLUSION: Routine preoperative CXR did not impact staging or lead to changes in the treatment of breast cancer patients. Therefore, routine CXR cannot be justified and should be omitted.FUNDING: none.TRIAL REGISTRATION: The study was approved by the local hospital legal department (Herlev and Gentofte Hospital) as quality assurance research (workzone number: 19000557).
AB - INTRODUCTION: Chest X-rays (CXRs) are performed routinely as part of staging of primary breast cancer patients in most breast units in Denmark. However, several international studies have found exceedingly low detection rates for occult pulmonary metastatic disease among breast cancer patients. Even so, no data have previously been published on Danish patients.METHODS: A retrospective study was conducted of all breast cancer patients undergoing CXRs at the Department of Breast Surgery, Herlev Hospital, from April 2016 to December 2017. The primary outcome was detection of pulmonary metastases on CXRs at the time of the patient's breast cancer diagnosis. The follow-up period was 12 months.RESULTS: A total of 1,014 patients were included in this study. Among these, 11 (1%) had a positive CXR and 1,003 (99%) had a negative CXR. Three (0.3%) patients were diagnosed with lung metastases but had false negative CXRs. The sensitivity was 0%, the specificity was 98.9%, the positive predictive value was 0% and the negative predictive value was 99.6%.CONCLUSION: Routine preoperative CXR did not impact staging or lead to changes in the treatment of breast cancer patients. Therefore, routine CXR cannot be justified and should be omitted.FUNDING: none.TRIAL REGISTRATION: The study was approved by the local hospital legal department (Herlev and Gentofte Hospital) as quality assurance research (workzone number: 19000557).
KW - Humans
KW - Female
KW - Radiography, Thoracic
KW - Retrospective Studies
KW - Breast Neoplasms/surgery
KW - X-Rays
KW - Radiography
KW - Lung Neoplasms/diagnostic imaging
KW - Neoplasm Staging
M3 - Journal article
C2 - 36331153
VL - 69
JO - Danish Medical Journal
JF - Danish Medical Journal
SN - 2245-1919
IS - 11
M1 - A06220380
ER -