The Yield of Staging Investigations in Patients with Breast Cancer Planned for Neoadjuvant Chemotherapy

BACKGROUND: Patients with breast cancer planned for neoadjuvant chemotherapy (NAC) represent a diverse population including high-risk early breast cancer (EBC) and locally advanced breast cancer (LABC). Staging investigations are routinely performed, but the clinical utility is unclear. METHODS: Using a provincial cancer registry, we identified breast cancer patients referred for NAC between 2020 and 2022. Patients with staging investigations were stratified into EBC (anatomic clinical stage I-II) and LABC (stage III). Rates of metastatic (M1) disease and associated factors were assessed. RESULTS: < 0.001). A higher cT/N stage correlated with M1 disease in LABC, although most subgroups demonstrated rates of ≥10%. CONCLUSIONS: These findings support a risk-adapted approach to pre-treatment staging in patients planned for NAC, omitting staging in asymptomatic cT1-2N0 disease, considering it for node-positive EBC, and performing it routinely in LABC.