[Cost-benefit in the study of the dissemination of stage I and II in breast cancer].

BACKGROUND

Chest X ray, abdominal ultrasound and bone scintigraphy are usually requested to study a possible dissemination of breast carcinoma.

AIM

To study the yield and costs of these exams in the study of dissemination of stage I and II breast carcinoma.

MATERIAL AND METHODS

A retrospective analysis of patients operated for a breast carcinoma in a public surgical service. A chest X ray, abdominal ultrasound and bone scintigraphy was requested to all patients in the immediate postoperative period. Age, stage according to pathological TNM and costs per patient were registered.

RESULTS

Of 210 women operated, 40 were in stage I (19%) and 85 in stage II (41%). Dissemination study was negative in all stage I patients and in all but two patients in stage II. The yield for detection of distant metastases in these patients was 0.9% for chest X ray, 0% for abdominal ultrasound and 0.9% for bone scintigraphy. The total cost of the study, in Chilean pesos, was $10,369,620 in a public hospital and $16,535,400 in a private clinic.

DISCUSSION

Additional exams to detect distant metastases in early stages of breast carcinoma have a low yield and high costs.