FDG-PET/CT Skull Base to Mid-Thigh In asymptomatic patients with a history of breast cancer who received treatment for curative intent, there is no evidence to support the use of FDG-PET/CT for surveillance of distant metastatic disease. The ASCO, NCCN, ESMO, and ESO all recommend against the routine use of imaging to screen for distant disease recurrence [126,128,209,210]. Mammography Diagnostic There is no evidence to support the use of mammography to evaluate suspected distant metastatic disease unless the recurrence suspected is in the axillary region. MRI Head Without and With IV Contrast There is no evidence supporting the use of MRI head without and with IV contrast in asymptomatic women for surveillance. In asymptomatic patients with a history of breast cancer who received treatment for curative intent, there is no role for imaging to screen for distant recurrences. The ASCO, NCCN, ESMO, and ESO all recommend against the routine use of imaging to screen for distant disease recurrence [126,128,209,210]. MRI Head Without IV Contrast There is no evidence supporting the use of MRI head without IV contrast in asymptomatic women for surveillance. US Axilla There is no evidence supporting the use of US axilla in asymptomatic women for surveillance of distant metastatic disease. Variant 11: Suspected distant recurrence of breast cancer based on symptoms, physical examination, or laboratory value. Regardless of clinical stage at time of original presentation. Bone Scan Whole Body In the setting of suspected distant recurrence, bone scan along with chest, abdomen, and pelvis CT is recommended by the NCCN [126]. CT Chest, Abdomen, and Pelvis With IV Contrast In the setting of suspected distant recurrence, bone scan plus chest, abdomen, and pelvis CT is recommended by the NCCN [172].
Imaging of Invasive Breast Cancer. FDG-PET/CT Skull Base to Mid-Thigh In asymptomatic patients with a history of breast cancer who received treatment for curative intent, there is no evidence to support the use of FDG-PET/CT for surveillance of distant metastatic disease. The ASCO, NCCN, ESMO, and ESO all recommend against the routine use of imaging to screen for distant disease recurrence [126,128,209,210]. Mammography Diagnostic There is no evidence to support the use of mammography to evaluate suspected distant metastatic disease unless the recurrence suspected is in the axillary region. MRI Head Without and With IV Contrast There is no evidence supporting the use of MRI head without and with IV contrast in asymptomatic women for surveillance. In asymptomatic patients with a history of breast cancer who received treatment for curative intent, there is no role for imaging to screen for distant recurrences. The ASCO, NCCN, ESMO, and ESO all recommend against the routine use of imaging to screen for distant disease recurrence [126,128,209,210]. MRI Head Without IV Contrast There is no evidence supporting the use of MRI head without IV contrast in asymptomatic women for surveillance. US Axilla There is no evidence supporting the use of US axilla in asymptomatic women for surveillance of distant metastatic disease. Variant 11: Suspected distant recurrence of breast cancer based on symptoms, physical examination, or laboratory value. Regardless of clinical stage at time of original presentation. Bone Scan Whole Body In the setting of suspected distant recurrence, bone scan along with chest, abdomen, and pelvis CT is recommended by the NCCN [126]. CT Chest, Abdomen, and Pelvis With IV Contrast In the setting of suspected distant recurrence, bone scan plus chest, abdomen, and pelvis CT is recommended by the NCCN [172].