In which scenarios do you stage breast cancer using CT and nuclear bone scans versus PET-CT?

In a recent study (Dayes et al., PMID 37235845), systemic staging with FDG PET-CT more frequently changed the clinical stage from IIB or III breast cancer to stage IV disease (23% metastases detection rate) than staging with CTs of the chest, abdomen, pelvis, and a bone scan combined (11% metastases...

Agree that oligomet met dz is often biologically distinct. For TNBC/Her2+/high grade disease, I’d get PET/CT, whole body if you like. If oligomets are found then aggressive systemic therapy then if response, proceed with locoregional and consider definitive treatment (e.g., RT) to oligomet sites. Or...

PET CT accomplishes staging in most patients and requires just one test and no IV or PO contrast other than the isotope--easier on patients.