[Pretherapeutical diagnosis of metastases in carcinoma of the breast (author's transl)].

Conscientious pretherapeutic search for metastases is a prerequisite for every curative local therapy of breast carcinoma. This must be preceded by thorough physical checkup, supplemented by the usual blood tests, thoracic x-ray, and contralateral mammography. The axillary lymphatic nodes should be biopsied, since clinical assessment alone, unsupported by other examinations, yields false results in about one-third of the cases. Skeleton scintigraphy is recommended for routine skeleton diagnostics, possibly followed by specific roentgenography or tomography of individual skeleton sections. Bone marrow biopsy as well as individual biochemical examinations (discussed in this article in detail) are hardly useful in the search for hidden skeleton metastases, but they can be of importance in assessing the course of therapy. If there is the slightest clinical suspicion of metastases of the liver, brain or other organs, additional special examinations must be performed. Scintigraphy in combination with laparoscopy or ultrasound tomography is recommended in liver diagnostics. Brain metastases can be reliably detected by means of computer tomography.