Researchers: Ido Wolf¹, Bella Kaufman², Larysa Ryvo³

Background: The literature on the performance of auxiliary tests in early stage breast cancer (BC) is limited, and suggests that the use of tests in the diagnosis process varies between physicians and centers around the world, and in many cases tests are performed beyond the recommended guidelines.

Objectives: We focused on different reference tests which patients with BC at an early clinical stage went through, and whether or not they conformed to accepted guidelines.

Method: A review on the records of 178 early-stage BC patients who were treated in the Tel Aviv Medical Center Oncology Ward during 2014. All patients presented with clinical stage I or II of the disease. On the basis of each patient's personal data, a list of tests was prepared and compared to the NCCN guidelines effective in 2014.

Findings: The results showed that 76 patients (42% out of 178 patients), underwent additional tests after their diagnosis of stages I-II. A total of 128 additional tests were performed, and all were in strict contrast to the NCCN recommendations. Only 2 tests (1.1%) yielded positive results, however they did not lead to further testing, nor did the positive outcome had a clinical significance for the patients. Patients under the age of 50 were sent to a greater number of tests relative to patients over the age of 50 (P=0.016) and Pri/Pre-menopausal patients underwent further investigation in contrast to post-menopausal patients (P=0.02).

Conclusions: There is an over-testing of women diagnosed with BC at an early stage, especially younger patients.

Recommendations: Over-testing entails medical damage as well as a significant economic burden on health services, which is why improving our understanding of the diagnosis process in early stage BC is crucial.

Research end date: 10/2018