Screening for metastatic disease in newly diagnosed breast cancer patients. What is cost-effective?
1Department of Oncology, University Hospital of Tromsø, Norway. jannorum@fagmed.uit.no
Background:
Significant health care resources are today spent on diagnosing and treatment of early breast cancer.
Materials And Methods:
98 consecutive patients referred to our oncological unit between January 1997 and June 1998 underwent an evaluation programme including thoracic X-ray, liver and bone scan and blood test. When findings suspected for metastatic disease were revealed, further examinations (CT-scan, MRI) were performed.
Results:
Whereas the screening programme disclosed four cases (4%) of distant metastasis, several patients had to suffer the psychological distress of false positive results. One in three suspicious thoracic X-rays, two in two liver scans and 18 out of 21 suspected bone scans were concluded false positive in terms of metastatic disease. A screening programme including blood test and thoracic X-ray alone, would have mis-classified one out of 98 patients.
Conclusion:
This study indicated thoracic X-ray and blood test as being sufficient and 110 Pounds per patient screened could be saved.
