Diagnosis, staging and follow-up in breast cancer patients

The role of imaging in the diagnosis and local staging of breast cancer is an important issue. Current guidelines recommend mammography for diagnosis of breast cancer, and ultrasound is often used as an additional imaging option. The usage of magnetic resonance imaging (MRI) is a controversial issue. The rationale for initial staging in breast cancer patients is the identification of gross evidence of metastatic disease that would influence further treatment strategies. However, so far, early detection of metastatic disease has had no relevant impact on patient survival. Follow-up examinations can help to detect early recurrences which are potentially curable but might impair quality of life. Disseminated tumor cells (DTCs) are an independent prognostic marker in breast cancer and a potential new staging tool. Detection of DTCs in bone marrow offers a wide spectrum of applications reaching from individual risk assessment to characterization of target antigen expression with consequent appropriate treatment choice. This review describes and discusses new aspects of these topics presented at the 10th St. Gallen International Conference on 'Primary therapy of early breast cancer' 2007.