For which patients, if any, do you typically order additional imaging workup for staging in early-stage breast cancer?

Many studies have shown the true-positive rate of distant metastases on pretreatment imaging to be a few percent (at most) for patients with Clinical Anatomic Stage I-II cancers. The false-positive rate is much higher. Hence, such imaging should only be used when patients have suspicious symptoms or...

Some series quoted above looking at the utility of PETCT in staging breast cancer were from the early 2000s. Since that time, PETCT technology including image resolution and sensitivity has dramatically improved (Vandenberghe et al., PMID 32451783).

A study had a very recent look at PETCT in stage I...

In the absence of clinical signs/symptoms of metastatic disease, routine systemic imaging is not indicated for patients with early-stage breast cancer. Metastatic disease was detected by a positive liver ultrasound or a positive chest x-ray in 6% and 7% of stage III patients. Bone scans identified m...