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Breast Cancer — SCE Medical Oncology MCQ

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EasyBreast CancerBreast CancerSCE Medical Oncology

A 40-year-old woman with newly diagnosed breast cancer undergoes staging with CT and bone scan. She has a 3.5 cm ER+/HER2+ tumour with 2 positive axillary nodes but no distant metastases. Why is PET-CT not routinely recommended for staging early breast cancer?

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Correct answer: C — PET-CT has insufficient sensitivity for small metastases and high false-positive rate in early-stage disease, and does not improve outcomes

NICE NG101 does not recommend PET-CT for routine staging of early breast cancer. For stage I-IIA, the risk of occult distant metastases is low (<5%), and PET-CT has a high false-positive rate leading to unnecessary biopsies and patient anxiety. CT chest/abdomen and bone scan (or bone scintigraphy) are recommended for stage IIB+ or symptomatic patients. PET-CT may be considered when conventional staging is equivocal.

Reference: NICE NG101 Early and locally advanced breast cancer; ESMO 2024 Early Breast Cancer Guidelines