NCCN guidelines recommend PET/CT as an optional additional test prior to preoperative systemic therapy to evaluate for distant disease if the tumor size is >2 cm (T2) or there are positive lymph nodes, or tumor size is >1 cm (T1c) and HER2+, or there is triple-negative disease [126], because these subtypes tend to be more aggressive with earlier spread to extraosseous locations compared with other molecular subtypes as described above. Mammography Diagnostic There is no evidence to support the use of diagnostic mammography to evaluate for distant disease. Imaging of Invasive Breast Cancer Mammography With IV Contrast There is no evidence to support the use of mammography with IV contrast to evaluate for distant disease. MRI Breast Without and With IV Contrast There is no evidence to support the use of MRI breast without and with IV contrast to evaluate for distant disease. MRI Breast Without IV Contrast There is no evidence to support the use of noncontrast breast MRI in evaluating the extent of disease. MRI Head Without IV Contrast There is no evidence to support the use of MRI head without IV contrast to evaluate for distant disease. US Axilla There is no evidence to support the use of US axilla to evaluate for distant disease. US Breast There is no evidence to support the use of US breast to evaluate for distant disease. Variant 6: Surveillance. Regardless of clinical stage of breast cancer at time of original presentation. Evaluation for local recurrence in patient with history of BCT. Breast-conserving treatment (BCT) of lumpectomy followed by whole-breast radiation is the most common treatment following a diagnosis of stage I and II breast cancer. Long-term studies show no significant difference in survival rates of patients treated with BCT versus mastectomy. Locoregional recurrence typically occurs 3 to 6 years post-treatment, at an average annual rate of 1% to 2.5% per year [167,168].
Imaging of Invasive Breast Cancer. NCCN guidelines recommend PET/CT as an optional additional test prior to preoperative systemic therapy to evaluate for distant disease if the tumor size is >2 cm (T2) or there are positive lymph nodes, or tumor size is >1 cm (T1c) and HER2+, or there is triple-negative disease [126], because these subtypes tend to be more aggressive with earlier spread to extraosseous locations compared with other molecular subtypes as described above. Mammography Diagnostic There is no evidence to support the use of diagnostic mammography to evaluate for distant disease. Imaging of Invasive Breast Cancer Mammography With IV Contrast There is no evidence to support the use of mammography with IV contrast to evaluate for distant disease. MRI Breast Without and With IV Contrast There is no evidence to support the use of MRI breast without and with IV contrast to evaluate for distant disease. MRI Breast Without IV Contrast There is no evidence to support the use of noncontrast breast MRI in evaluating the extent of disease. MRI Head Without IV Contrast There is no evidence to support the use of MRI head without IV contrast to evaluate for distant disease. US Axilla There is no evidence to support the use of US axilla to evaluate for distant disease. US Breast There is no evidence to support the use of US breast to evaluate for distant disease. Variant 6: Surveillance. Regardless of clinical stage of breast cancer at time of original presentation. Evaluation for local recurrence in patient with history of BCT. Breast-conserving treatment (BCT) of lumpectomy followed by whole-breast radiation is the most common treatment following a diagnosis of stage I and II breast cancer. Long-term studies show no significant difference in survival rates of patients treated with BCT versus mastectomy. Locoregional recurrence typically occurs 3 to 6 years post-treatment, at an average annual rate of 1% to 2.5% per year [167,168].