title: Association between number and sites of new bone scan abnormalities and presence of skeletal metastases in patients with breast cancer.
abstract: Review of 1,441 bone scans performed on 242 breast cancer patients without known skeletal metastases identified 239 scans with new abnormalities. Findings on 54 of these 239 scans (23%) represented bone metastases. The proportion of scans reflecting metastases, grouped by the number of new abnormalities, was: (1) 20/182 (11%); (2) 9/26 (35%); (3) 4/9 (45%); (4) 1/2 (50%); greater than or equal to 5-20/20 (100%). When metastatic disease presented as a bone scan with 1-4 new abnormalities, the spine was the most common site of involvement (18 of 34 (53%)), followed by the skull (5/34; 15%), extremities and sternum (each 4/34; 12%). Rib lesions were the most common new findings on scans with less than 5 new abnormalities (seen on 76 of 219 scans (35%)) but only infrequently represented metastases (n = 2). Considering as indicative of malignancy only, those bone scans which demonstrated either (a) greater than or equal to 5 new abnormalities, (b) initial radiographic correlation suggestive of metastases, or (c) thoracic spine lesions with normal correlative radiographs, the presence of skeletal metastatic disease could be predicted with a sensitivity of 0.80 and a specificity of 0.94.
authors.affiliation: Department of Radiology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
authors.forename: A F
authors.initials: AF
authors.lastname: Jacobson
authors.forename: P C
authors.initials: PC
authors.lastname: Stomper
authors.forename: M S
authors.initials: MS
authors.lastname: Jochelson
authors.forename: D M
authors.initials: DM
authors.lastname: Ascoli
authors.forename: I C
authors.initials: IC
authors.lastname: Henderson
authors.forename: W D
authors.initials: WD
authors.lastname: Kaplan
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000556:secondary*; D001943:Breast Neoplasms / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015995:Prevalence; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012888:Skull Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D013667:Technetium
chemical_list: D013667:Technetium