Screening for metastatic disease in newly diagnosed breast cancer patients. What is cost-effective?

Abstract

Background: Significant health care resources are today spent on diagnosing and treatment of early breast cancer.

Materials and methods: 98 consecutive patients referred to our oncological unit between January 1997 and June 1998 underwent an evaluation programme including thoracic X-ray, liver and bone scan and blood test. When findings suspected for metastatic disease were revealed, further examinations (CT-scan, MRI) were performed.

Results: Whereas the screening programme disclosed four cases (4%) of distant metastasis, several patients had to suffer the psychological distress of false positive results. One in three suspicious thoracic X-rays, two in two liver scans and 18 out of 21 suspected bone scans were concluded false positive in terms of metastatic disease. A screening programme including blood test and thoracic X-ray alone, would have mis-classified one out of 98 patients.

Conclusion: This study indicated thoracic X-ray and blood test as being sufficient and 110 Pounds per patient screened could be saved.