Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1977 Sep;186(3):363–368. doi: 10.1097/00000658-197709000-00014

An evaluation of bone scans as screening procedures for occult metastases in primary breast cancer.

R R Baker, E R Holmes 3rd, P O Alderson, N F Khouri, H N Wagner Jr
PMCID: PMC1396331  PMID: 889378

Abstract

Preoperative bone scans were obtained in 104 patients with operable breast cancer. Areas of increased radioactivity detected by the bone scan were correlated with appropriate radiographs. One of 64 patients (1.5%) with clinical Stage I and Stage II breast cancer had a metastatic lesion detected by the preoperative bone scan. In contrast, 10 of 41 patients (24%) with Stage III breast cancer had occult metastatic lesions detected by the preoperative bone scan. The majority of patients with abnormal bone scans and no radiographic evidence of a benign lesion to explain the cause of the increased radioactivity proved to have metastatic breast cancer on follow-examination. Even though 20% of patients with operable breast cancer will eventually develop bone metastases, our results indicate that preoperative bone scans are not an effective means of predicting which patients with Stage I and Stage II disease will develop metastatic breast cancer. Because of the considerably increased frequency of detection of occult metastases in patients with Stage III breast cancer, bone scans should be obtained routinely in the preoperative assessment of these patients.

Full text

PDF
363

Images in this article

364Figs. 1a and b.
on p.364
365Figs. 2a and b.
on p.365
365Figs. 3a-d.
on p.365

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Belliveau R. E., Spencer R. P. Incidence and sites of bone lesions detected by 99mTc-polyphosphate scans in patients with tumors. Cancer. 1975 Aug;36(2):359–363. doi: 10.1002/1097-0142(197508)36:2<359::aid-cncr2820360210>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  2. Charkes N. D., Malmud L. S., Caswell T., Goldman L., Hall J., Lauby V., Lightfoot W., Maier W., Rosemond G. Preoperative bone scans. Use in women with early breast cancer. JAMA. 1975 Aug 11;233(6):516–518. doi: 10.1001/jama.233.6.516. [DOI] [PubMed] [Google Scholar]
  3. Citrin D. L., Bessent R. G., Greig W. R., McKellar N. J., Furnival C., Blumgart L. H. The application of the 99Tcm phosphate bone scan to the study of breast cancer. Br J Surg. 1975 Mar;62(3):201–204. doi: 10.1002/bjs.1800620307. [DOI] [PubMed] [Google Scholar]
  4. Citrin D. L., Furnival C. M., Bessent R. G., Greig W. R., Bell G., Blumgart L. H. Radioactive technetium phosphate bone scanning in preoperative assessment and follow-up study of patients with primary cancer of the breast. Surg Gynecol Obstet. 1976 Sep;143(3):360–364. [PubMed] [Google Scholar]
  5. El-Domeiri A. A., Shroff S. Role of preoperative bone scan in carcinoma of the breast. Surg Gynecol Obstet. 1976 May;142(5):722–724. [PubMed] [Google Scholar]
  6. Fletcher J. W., Solaric-George E., Henry R. E., Donati R. M. Radioisotopic detection of osseius metastases. Evaluation of 99mTc polyphosphate and 99mTc pyrophosphate. Arch Intern Med. 1975 Apr;135(4):553–557. [PubMed] [Google Scholar]
  7. Galasko C. S. The significance of occult skeletal metastases, detected by skeletal scintigraphy, in patients with otherwise apparently 'early' mammary carcinoma. Br J Surg. 1975 Sep;62(9):694–696. doi: 10.1002/bjs.1800620906. [DOI] [PubMed] [Google Scholar]
  8. Green D., Jeremy R., Towson J., Morris J. The role of fluorine i8 scanning in the detection of skeletal metastases in early breast cancer. Aust N Z J Surg. 1973 Dec;43(3):251–254. doi: 10.1111/j.1445-2197.1973.tb05696.x. [DOI] [PubMed] [Google Scholar]
  9. Hoffman H. C., Marty R. Bone scanning. Its value in the preoperative evaluation of patients with suspicious breast masses. Am J Surg. 1972 Aug;124(2):194–199. doi: 10.1016/0002-9610(72)90013-x. [DOI] [PubMed] [Google Scholar]
  10. Hopkins G. B., Kristensen K. A., Campbell C. G. Skeletal scintigraphy. The use of technetium 99M-labeled complexes in the detection of early osseous involvement by metastatic tumors. West J Med. 1974 Jun;120(6):448–451. [PMC free article] [PubMed] [Google Scholar]
  11. Hopkins G. B., Kristensen K. A. Whole body skeletal scintiphotography in the detection of occult metastatic breast carcinomas. Calif Med. 1973 Oct;119(4):10–13. [PMC free article] [PubMed] [Google Scholar]
  12. Lentle B. C., Burns P. E., Dierich H., Jackson F. I. Bone scintiscanning in the initial assessment of carcinoma of the breast. Surg Gynecol Obstet. 1975 Jul;141(1):43–47. [PubMed] [Google Scholar]
  13. McDougall I. R., Kriss J. P. Screening for bone metastases. Are only scans necessary? JAMA. 1975 Jan 6;231(1):46–50. doi: 10.1001/jama.231.1.46. [DOI] [PubMed] [Google Scholar]
  14. O'Mara R. E. Skeletal scanning in neoplastic disease. Cancer. 1976 Jan;37(1 Suppl):480–486. doi: 10.1002/1097-0142(197601)37:1+<480::aid-cncr2820370713>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  15. Robbins G. F., Knapper W. H., Barrie J., Kripalani I., Lawrence J. Metastatic bone disease developing in patients with potentially curable breast cancer. Cancer. 1972 Jun;29(6):1702–1704. doi: 10.1002/1097-0142(197206)29:6<1702::aid-cncr2820290639>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  16. Sklaroff R. B., Sklaroff D. M. Bone metastases from breast cancer at the time or radical mastectomy as detected by bone scan. Eight-year follow-up. Cancer. 1976 Jul;38(1):107–111. doi: 10.1002/1097-0142(197607)38:1<107::aid-cncr2820380119>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES