Choosing Wisely, Using Wisely: Diagnostics, Defining the Disease Stage, and Deciding about Breast Cancer Treatment

Among breast cancer patients, diagnostics differs depending on the disease stage that patients are in because in every disease stage other forms of diagnostics can be considered to be more precise. Whereas some forms of diagnostics are particularly effective in early-stage breast cancer identification, others are more effective in late-stage identification. This perspective looks at new oncologic diagnostic developments that may engender an emotional rollercoaster ride among metastatic breast cancer patients and their close relatives and healthcare professionals. The text touches upon the impact that new diagnostics can have on treatment approaches, especially if those diagnostic outcome measures could change the disease stage from curable (stage III) to incurable (stage IV). A multidisciplinary approach in which diagnostics, pathology, the view of the treating doctor, and the patient's voice are included probably guarantees the best possible treatment and care for breast cancer patients in these so-called gray oncologic areas. This perspective refers to new diagnostic oncologic developments that may sometimes create an emotional rollercoaster ride among metastatic breast cancer (MBC) patients and their close relatives and healthcare professionals. It touches upon the impact that new diagnostics can have on treatment approaches, especially if diagnostic outcome measures can change the disease stage from curable (stage III) to incurable (stage IV). The text specifically touches upon a gray area in oncology in which a proportion of patients could be cured, such as with oligometastatic disease (OMD).