Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Apr 5:3:176.
doi: 10.1186/2193-1801-3-176. eCollection 2014.

Patient perceptions and expectations regarding imaging for metastatic disease in early stage breast cancer

Demetrios Simos  1 , Brian Hutton  2 , Ian D Graham  2 , Angel Arnaout  3 , Jean-Michel Caudrelier  4 , Sasha Mazzarello  5 , Mark Clemons  6
Affiliations

Patient perceptions and expectations regarding imaging for metastatic disease in early stage breast cancer

Demetrios Simos et al. Springerplus. .

Abstract

Purpose: The probability of detecting radiologically evident metastatic disease in asymptomatic women with newly diagnosed operable breast cancer is low. Despite the recommendations of most practice guidelines imaging is still frequently performed. Relatively little is known about what patients believe is important when it comes to radiologic staging.

Methods: Patients with early stage breast cancer who had completed their definitive breast surgery were surveyed about their personal experiences, perceptions, and expectations on the issue of perioperative imaging for distant metastatic disease.

Results: Over a 3 month period, 245 women with primary operable breast cancer completed the questionnaire (87.0% response rate) and 80.8% indicated having had at least one imaging test for distant metastatic disease. These were either of the thorax (72.2%), abdomen (55.9%) or skeleton (65.3%) with a total of 701 imaging tests (average of 3.5 tests per patient imaged) performed. Overall, 57.1% indicated that they would want imaging done if the chance of detecting metastases was ≤10%. Although 80.0% of patients indicated that, "doing whatever their doctor recommended" was important to them, 70.4% also noted that they would be uncomfortable if their physician did not order imaging, even if this was in keeping with practice guidelines.

Conclusions: Most patients with early stage breast cancer recall having imaging tests for distant metastases. Given the choice, most would prefer having imaging performed, even if this is not in line with current guidelines. If patient expectations are, in part, driving excessive imaging, new strategies addressing this are required.

Keywords: Guidelines; Imaging; Metastases; Operable breast cancer; Patient perceptions.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Patient reported imaging thresholds (N = 245).
Figure 2
Figure 2
Patient reported factors of importance (N = 245), QOL: quality of life.
Figure 3
Figure 3
Patient reported level of comfort if imaging not ordered (N = 245).
See this image and copyright information in PMC

References

    1. Alberta Health Services clinical practice guideline BR-012 version 2 effective July 2012 2014. http://www.albertahealthservices.ca/hp/if-hp-cancer-guidebr012-staging-i.... Accessed 27 February 2014
    1. Al-Husaini H, Amir E, Fitzgerald B, Wright F, Dent R, Fralick J, Clemons M. Prevalence of overt metastases in locally advanced breast cancer. Clin Oncol (R Coll Radiol) 2008;20:340–344. doi: 10.1016/j.clon.2008.03.006. - DOI - PubMed
    1. Barrett T, Bowden DJ, Greenberg DC, Brown CH, Wishart GC, Britton PD. Radiological staging in breast cancer: which asymptomatic patients to image and how. Br J Cancer. 2009;101:1522–1528. doi: 10.1038/sj.bjc.6605323. - DOI - PMC - PubMed
    1. Brennan ME, Houssami N. Evaluation of the evidence on staging imaging for detection of asymptomatic distant metastases in newly diagnosed breast cancer. Breast. 2012;21:112–123. doi: 10.1016/j.breast.2011.10.005. - DOI - PubMed
    1. Crivello ML, Ruth K, Sigurdson ER, Egleston BL, Evers K, Wong YN, Boraas M, Bleicher RJ. Advanced imaging modalities in early stage breast cancer: preoperative use in the Unites States Medicare population. Ann Surg Oncol. 2013;20:102–110. doi: 10.1245/s10434-012-2571-4. - DOI - PMC - PubMed

LinkOut - more resources