After Breast Cancer Diagnosis, Tests Overdone?
Routine X-Rays, Bone Scans Show Low Detection Rate for Spotting Breast Cancer Spread
Low Detection Rates continued...
The answer: Not really.
The tests had very low detection rates of cancer spread, particularly for the 1,482 women with stage I and II cancer: 2.43% for bone scans, 0.82% for liver ultrasound, and 0.51% for chest X-ray.
In the 400 women with stage III cancer, the detection rates were somewhat higher, particularly with bone scans: 12.5%, vs. 4.2% and 4.57% for liver ultrasound and chest X-ray, respectively.
"We must rethink the utility of these tests. Are they saving lives? How many false positives are there? How many false negatives? Likely a lot. Women with early-stage cancer may not need any of these tests," Staley says. "And we don't even know which tests are best for women with stage III cancer."
Although she and Seidman don’t have the answers, they agree a head-to-head comparison of these radiological tests with more sensitive imaging, such as CT or PET, looking at effectiveness and cost, is a logical next step.
ASCO isn't the only medical group taking a long hard look at whether procedures and tests work and work well enough to justify their cost. The American Board of Internal Medicine Foundation’s Choosing Wisely campaign, for example, developed a list of commonly used tests or treatments whose necessity is not supported by high-level evidence.
These findings were presented at a medical conference. They should be considered preliminary, as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.