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Background: International guidelines do not recommend routine staging of EBCs. However, most clinicians still perform staging investigations (SI) selectively for several reasons. We examined our practice of selective use of SI to determine its performance, clinical utility, and cost‐effectiveness. Methods: We performed this retrospective study on patients who had treatment for AJCC stage I or stage II breast cancer through Eastern health Breast and cancer centre, Melbourne, for 50 months from January 2012. Result: Our practice of selective use resulted in SI in 41% of all EBCs (95% CI 37–46%). Overall yield was 3% (95% CI 0.4–5.4%) with a false positive rate of 22% (95% CI 1628%) and a false‐negative rate of 45% (95% CI 11–79%). The sensitivity of SI is 55% (95% CI 21–89%) with a negative predictive value of 97% (95% CI 94.8–99.9%). None of the treatment components was found to be significantly changed based on findings on SI. There was no significant difference in all‐cause mortality or new distant recurrence in the staged and non‐staged groups. Identification of six new metastases cost at least 422 021 AUD. The approximate cost to stage one EBC is 2069 AUD. 'Number needed to scan' to detect one new metastasis is 34 at the expense of 70337AUD. Conclusion: Selective use of SI results in better yield. However, the clinical utility of these results is not significant. It is debatable if this level of expenditure is cost‐effective. Our results point to a need for change in practice. [ABSTRACT FROM AUTHOR]

Recurrent spontaneous haemarthrosis after knee arthroplasty occurs in less than 1% of cases, commonly thought to be the result of impingement of hypertrophic vascular synovium or fat pads, and exacerbated by anti-coagulation or anti-platelet therapy. Traditional treatment comprises an initial period of rest followed by open or arthroscopic washout, and by synovectomy if bleeding recurs or fails to settle. We present three cases of recurrent haemarthrosis following knee arthroplasty, which were successfully treated by angiography and feeding vessel coil embolization. An injury to one of the genicular arteries was identified as the cause of bleeding in all three cases; one manifest as a traumatic arteriovenous fistula. Bleeding ceased in all cases without recurrence (follow-up period 6 months – 5 years, median of 2 years). Endovascular treatment offers a minimally invasive treatment option in selected cases of recurrent post-operative haemarthrosis. [ABSTRACT FROM AUTHOR]