ACR Appropriateness Criteria Stage I Breast Cancer: Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women

Linda Moy, Mary S. Newell, Mary C. Mahoney, Lisa Bailey, Lora D. Barke, Selin Carkaci, Carl D'Orsi, Sharad Goyal, Bruce G. Haffty, Jennifer A. Harvey, Mary K. Hayes, Peter M. Jokich, Su Ju Lee, Martha B. Mainiero, David A. Mankoff, Samir B. Patel, Monica Yepes

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Women newly diagnosed with stage 1 breast cancer have an early-stage disease that can be effectively treated. Evidence provides little justification for performing imaging to exclude metastasis in asymptomatic women with stage I breast cancer. No differences have been found in survival or quality of life in women regardless of whether they underwent initial workup for metastatic disease. These women generally prefer intensive follow-up to detect an early recurrence. However, survival rates do not differ between women who obtain intensive screening and surveillance, with imaging and laboratory studies, and women who undergo testing only as a result of development of symptoms or findings on clinical examinations. In addition, quality of life is similar for women who undergo intensive surveillance compared with those who do not. American Society of Clinical Oncology and National Comprehensive Cancer Network guidelines state that annual mammography is the only imaging examination that should be performed to detect a localized breast recurrence in asymptomatic patients. Additional imaging may be needed if the patient has locoregional symptoms. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review by the panel include extensive analysis of current medical literature from peer-reviewed journals and application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures. When evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)e43-e52
JournalJournal of the American College of Radiology
Volume13
Issue number11
DOIs
StatePublished - Nov 1 2016

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Breast Neoplasms
Neoplasm Metastasis
Recurrence
Guidelines
Quality of Life
Expert Testimony
Mammography
Breast
Survival Rate
Survival
Therapeutics
Neoplasms

Keywords

  • Appropriateness Criteria
  • early-stage breast cancer
  • metastatic disease
  • recurrence

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

ACR Appropriateness Criteria Stage I Breast Cancer : Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women. / Moy, Linda; Newell, Mary S.; Mahoney, Mary C.; Bailey, Lisa; Barke, Lora D.; Carkaci, Selin; D'Orsi, Carl; Goyal, Sharad; Haffty, Bruce G.; Harvey, Jennifer A.; Hayes, Mary K.; Jokich, Peter M.; Lee, Su Ju; Mainiero, Martha B.; Mankoff, David A.; Patel, Samir B.; Yepes, Monica.

In: Journal of the American College of Radiology, Vol. 13, No. 11, 01.11.2016, p. e43-e52.

Research output: Contribution to journalArticle

Moy, L, Newell, MS, Mahoney, MC, Bailey, L, Barke, LD, Carkaci, S, D'Orsi, C, Goyal, S, Haffty, BG, Harvey, JA, Hayes, MK, Jokich, PM, Lee, SJ, Mainiero, MB, Mankoff, DA, Patel, SB & Yepes, M 2016, 'ACR Appropriateness Criteria Stage I Breast Cancer: Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women', Journal of the American College of Radiology, vol. 13, no. 11, pp. e43-e52. https://doi.org/10.1016/j.jacr.2016.09.023
Moy, Linda ; Newell, Mary S. ; Mahoney, Mary C. ; Bailey, Lisa ; Barke, Lora D. ; Carkaci, Selin ; D'Orsi, Carl ; Goyal, Sharad ; Haffty, Bruce G. ; Harvey, Jennifer A. ; Hayes, Mary K. ; Jokich, Peter M. ; Lee, Su Ju ; Mainiero, Martha B. ; Mankoff, David A. ; Patel, Samir B. ; Yepes, Monica. / ACR Appropriateness Criteria Stage I Breast Cancer : Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women. In: Journal of the American College of Radiology. 2016 ; Vol. 13, No. 11. pp. e43-e52.
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