Limit the use of diagnostic procedures in case of low-risk prostate and breast cancer. Avoid the use of serum biomarkers in early stage breast cancer.

Type of practice


Topic Area


Proper staging is crucial in cancer patients. However, in specific clinical settings such a low-risk breast and prostate cancer, a complete staging work-out can be avoided. Inappropriate diagnostic procedures may increase costs and delay meaningful treatments such as radiation therapy. The use of serum biomarkers in low-risk breast cancer patients has shown to have no benefit. The possible presence of false positive cases may induce the overprescription of medical exams, may lead to overtreatment with consequent psychological effects. This situation should be avoided whenever possible.


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2. National Comprehensive Cancer Network: NCCN clinical practice guidelines in oncology (NCCN Guidelines)- Prostate Cancer Version 2.2021 (pag.PROS-2).
3. National Comprehensive Cancer Network: NCCN clinical practice guidelines in oncology (NCCN Guidelines)- Breast Cancer Version 2.2021 (pag BINV-1)
4. Schnipper LE, Smith TJ, Raghavan D, Blayney DW, Ganz PA, Mulvey TM, Wollins DS. American Society of Clinical Oncology identifies five key opportunities to improve care and reduce costs: the top five list for oncology. J Clin Oncol. 2012 May 10;30(14):1715-24. doi: 10.1200/JCO.2012.42.8375. Epub 2012 Apr 3. PMID: 22493340.
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6. Cardoso F et al Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 30: 1194–1220, 2019, doi:10.1093/annonc/mdz173. (pag 1198)



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