The severity of breast cancer is described by five stages, depending on tumour size and location. Stage 0 means pre-cancerous cells are present in the breast (e.g. carcinoma in situ). Stage 1 means there is a small tumour in the breast, but no lymph node involvement (this is called invasive cancer). Stages 2 and 3 mean either that the tumour is larger or that there are some cancer cells in the lymph nodes of the armpit or other nearby tissues, such as the skin. Stage 4 means the cancer has spread to form tumours (metastases) in other, distant parts of the body. Severity increases with stage and consequently treatment options vary between stages.

Recommendations

If you have been diagnosed with stage 1 breast cancer, should you have staging examinations with conventional imaging techniques, such as X-rays, computed tomography scan or ultrasound scan?

No, for women with suspected clinical stage 1 breast cancer without symptoms of metastases, the ECIBC's Guidelines Development Group (GDG) suggests not using staging examinations with conventional imaging techniques.

And with positron emission tomography-computed tomography?

No, the GDG recommends not using staging examinations with positron emission tomography-computed tomography (PET-CT).

Who are these recommendations for?

  • You have been diagnosed with breast cancer
  • You do not have symptoms that suggest potential metastases
  • You may have been told by your healthcare professional that it could be stage 1 breast cancer

What would following these recommendations mean for you?

It might be important to speak with your healthcare professional about the different clinical stages of breast cancer and whether you have symptoms of metastases.

You may also wish to speak with your healthcare professional about:

  • risk of the cancer developing or spreading to other parts of the body
  • treatment for stage 1 breast cancer
  • anxiety and distress.

Additional considerations

This recommendation suggests not having staging examinations if you have been diagnosed with clinical stage 1 breast cancer, because there are probably greater harms than benefits.

The evidence suggests that using staging examinations at clinical stage 1 may not find more metastases and it may result in a slight increase of a false positive result. This means a woman would have further tests, including a biopsy, which will confirm that she does not have metastases, but may have suffered unnecessary anxiety and distress.

The GDG also noted that the costs of providing staging examinations to women with clinical stage 1 breast cancer are high.

Definitions

Metastasis refers to the spread of cancer cells from the place where they first formed to another part of the body.

Biopsy: a sample of tissue to be taken from your breast or elsewhere, to test for cancer.

Positron emission tomography-computed tomography is a medical procedure that uses radioactive substances to measure some biological processes.

Documentation for professionals