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. 2021 Feb 25;10(5):906.
doi: 10.3390/jcm10050906.

Usefulness of Staging Chest CT in Breast Cancer: Evaluating Diagnostic Yield of Chest CT According to the Molecular Subtype and Clinical Stage

Seulgi You  1 , Tae Hee Kim  1 , Doo Kyoung Kang  1 , Kyung Joo Park  1 , Young-Sil An  2 , Joo Sung Sun  1
Affiliations

Usefulness of Staging Chest CT in Breast Cancer: Evaluating Diagnostic Yield of Chest CT According to the Molecular Subtype and Clinical Stage

Seulgi You et al. J Clin Med. .

Abstract

The aim of this study is to investigate the clinical utility of staging chest CT in breast cancer by evaluating diagnostic yield (DY) of chest CT in detection of metastasis, according to the molecular subtype and clinical stage. This retrospective study included 840 patients with 855 breast cancers from January 2017 to December 2018. The number of patients in clinical stage 0/I, II, III and IV were 457 (53.5%), 298 (34.9%), 92 (10.8%) and 8 (0.9%), respectively. Molecular subtype was identified in 841 cancers and there were 709 (84.3%) luminal type, 55 (6.5%) human epidermal growth factor receptor 2 (HER2)-enriched type and 77 (9.2%) triple-negative (TN) type. The DYs in clinical stage 0/I, cII, cIII and cIV were 0.2% (1/457), 1.7% (5/298), 4.3% (4/92) and 100.0% (8/8), respectively. The DYs in luminal type, HER2-enriched type and TN type were 1.7% (12/709), 3.6% (2/55) and 2.6% (2/77), respectively. Clinical stage was associated with the DY (p = 0.000). However, molecular subtype was not related to the DY (p = 0.343). Molecular subtype could not provide useful information to determine whether staging chest CT should be performed in early-stage breast cancer. However, chest CT should be considered in advanced breast cancer.

Keywords: breast cancer; clinical stage; diagnostic yield; molecular subtype; staging chest CT.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient flow diagram showing reference standard for metastasis based on clinical stage.
Figure 2
Figure 2
56-year-old female with breast cancer in Lt breast. (A) On initial MRI, there was about a 3.5 cm irregular shape enhancing mass in her Lt breast with skin invasion and multiple metastatic lymph nodes in Lt axilla level I and II. Initial clinical stage was III based on MRI. (B) Multiple metastatic pulmonary nodules were detected on staging chest CT and clinical stage was upstaged from stage III to IV. (C) After neoadjuvant chemotherapy, primary breast mass and axillary lymph nodes decreased in size. (D) Pulmonary metastatic nodules also decreased in size after neoadjuvant chemotherapy, consistent with the response of primary lesion.
Figure 3
Figure 3
Patient flow diagram showing reference standard for metastasis based on molecular subtype. (A) Luminal type; (B) HER2-enriched type; (C) Triple-negative type.
Figure 3
Figure 3
Patient flow diagram showing reference standard for metastasis based on molecular subtype. (A) Luminal type; (B) HER2-enriched type; (C) Triple-negative type.
See this image and copyright information in PMC

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