title: Detection of breast carcinoma metastases in bone: relative merits of X-rays and skeletal scintigraphy.
abstract: Of 1116 patients receiving primary treatment for breast carcinoma at the Royal Marsden Hospital since 1976, 651 had an abnormal bone scintigram either at primary diagnosis (378) or on subsequent follow-up (273) and 167 developed radiographically detectable bone metastases (21 at the time of primary diagnosis). Comparison of bone scintigrams and X-rays showed that scintigraphy was an inaccurate localiser of existing radiographic detectable metastases. If X-rays alone are used to detect bone metastases a limited examination with five plates will detect metastases with 92% accuracy. After primary surgery, routine X-ray screening for bone metastases is not necessary since it is possible to identify patients at risk on the basis of clinical examination, chest X-ray, and serum alkaline phosphatase and gamma-glutamyl transpeptidase levels.
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms; D004164:Diphosphonates; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013902:Radiography, Thoracic; D011877:Radionuclide Imaging; D013667:Technetium; D013669:Technetium Tc 99m Medronate; D013997:Time Factors; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D004164:Diphosphonates; D013667:Technetium; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D013669:Technetium Tc 99m Medronate