Because radiologists will tend to over-stage rather than under-stage, relatively high over-staging rates (up to 50%) as compared with primary staging have been reported.
Including erosions only in the assessment of bone destruction in children may therefore lead to both over- and under-staging of disease.
The difference is particularly marked in the under-staging of DCIS.
VAM will under-stage disease less than half as often as will conventional core biopsy.
Specimens containing <3 CLNs retrieved during pCND (n = 38) were excluded to reduce the possibility of nodal under-staging.
Under-staging of stage 4 disease with CT is a possibility, since it is not sensitive in detecting small areas of cortical destruction [ 24].
In this study PET under-staged the extent of nodal disease in 19 (49%), whereas the CT/EUS combination over-staged the nodal stage in 14 (36%).
Over-staging may occur because peritumoral edematous changes may be mistaken for tumor and under-staging may occur when tumor penetration is below the resolution of sonography [ 19].
Evaluation of disease within the pelvis is better demonstrated with MRI but within the abdomen both techniques under-stage small tumour implants[ 2 ].
Mammotomy is significantly less likely to under-stage malignant disease when a B3 result is obtained compared to CB (17.5% versus 64%, respectively).
We found no significant differences in recurrence-free survival according to the number of nodes sampled and therefore no evidence of under-staging.
