Quality control in the locoregional treatment of
Diagnosis of distant disease
No evidence exists that any subset of tests is sufficiently accurate to exclude distant disease in primary operable breast cancer
. Therefore any tests will be performed on indication of symptoms and extent of local disease.
For patients with tumours suitable for primary surgery, with no clinical evidence of dissemination, a preoperative screening test should be chest X-ray, full blood count and liver function tests. For patients with clinically involved axillary nodes or being considered for neo-adjuvant therapy by the size and extent of the primary tumour, further screening tests should be arranged. These include liver imaging (computed tomography (CT)-scan or ultra sound) and skeletal survey (bone scan); tumour markers are optional.