E1629. Beyond the Axillary Lymph Nodes: The Spectrum of Metastatic Breast Cancer
  1. Christopher Doyle; Columbia / NYP
  2. Shawn Sun; Columbia / NYP
  3. Pooja Jairam; Columbia / NYP
  4. Cara Swintelski; Columbia / NYP
  5. Elise Desperito; Columbia / NYP
  6. Richard Ha; Columbia / NYP
Breast cancer is the most common cancer and 2nd leading cause of cancer death in women, projected to have 276,000 new cases diagnosed and 42,000 deaths in 2020. The mortality and its treatment is directly related to accurate staging. 4-10% of breast cancers are metastatic at presentation, and nearly 30% of women initially diagnosed with early stage disease will ultimately develop distant metastasis. Recognizing the sites and manifestations of metastatic disease in the staging of breast cancer as well as understanding emerging technologies to increase the sensitivity in detecting metastatic disease is crucial to optimize treatment.

Educational Goals / Teaching Points
The purpose of this presentation is to highlight common sites and manifestations of breast cancer metastasis beyond the axillary lymph nodes, demonstrate the spectrum of metastatic breast cancer as a systemic disease, review the appropriate use of imaging in the work up of cancer, and review emerging technologies in breast imaging. The target audience is breast radiologists, general radiologists, residents, and medical students.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will review the imaging work-up for a newly diagnosed breast cancer and overview the current National Comprehensive Cancer Network (NCCN) guidelines on imaging for metastatic disease. The imaging findings of metastatic breast cancer, particularly by MDP bone scintigraphy, CT C/A/P, and brain MRI and spine MRI when indicated will be discussed. New imaging techniques such as molecular breast imaging and its potential future uses for detecting breast cancer metastasis will be reviewed.

Accurate breast cancer staging is crucial in guiding treatment and optimizing outcome. Recognizing the sites to which breast cancer is likely to spread is vital to clinical practice. Understanding the uses and indications of available modalities as well as emerging technologies is critical for both general and breast radiologists.