The major information for staging of the breast cancer is the pathology report. However, a full history should be undertaken to assess any physical symptoms which may suggest metastatic disease. A full physical examination should be done to carefully assess other nodes, especially supraclavicular nodes, lungs, liver and bones. If the physical examination and history are normal and do not suggest metastatic disease, other staging investigations may not be necessary. If there are any findings these should have imaging and further laboratory investigations.

Prior to chemotherapy, a hematology and chemistry panel should be done to rule out bone or liver metastases and to ensure adequate marrow, hepatic and renal function. In node positive or locally advanced disease, a bone scan may be done if it is thought that there may be a risk of bone metastases at presentation or if a baseline test would be helpful. Baseline tumour markers CEA, CA15-3 and CA125 may be considered as part of the initial staging. If normal, they need not be repeated, unless there is a documented recurrence. If they are abnormal, they may suggest metastatic disease, possibly occult.