Je předoperační scintigrafie skeletu v časném stadiu karcinomu prsu T1N0 indikovaná a smysluplná

In the Czech Republic bone scintigraphy has been still routinely performed as a part of preoperative  staging examinations of early breast carcinomas, which are already in 42% diagnosed in the national breast cancer  screening program. Incidence of synchronnous distant metastases was analysed for a subgroup of T1N0 breast carcinomas using the database of the Czech National Cancer Registry. From 21 675  women with breast carcinomas T1N0 diagnosed in the decade of 2001-2010 the possible distant metastases of all types (M1) were found in 147 cases (0,68%). Since only approximately 40% of distant metastases are skeletal (M1 OSS), the probability of bone metastases in T1N0 breast cancer does not exceed 0,3-0,4%. Distant metastases were present in 0,5% in subgroup of well and moderately differentiated carcinomas and up to 1,2% in poorly differentiated and anaplastic tumors, but again only smaller half of them (0,2% and 0,5%) involve the bones. We conclude than preoperative bone scintigraphy is overused and not meaningful in more than 99% Czech women with early breast cancer T1N0.  Skeletal scintigraphy  as a staging procedure for small breast carcinoma T1N0 might be perhaps recommended only postoperatively and very selectively with consideration of individual risk factors and symptomatology.