Healing flare in skeletal metastases from breast cancer.
OBJECTIVE
To identify the frequency, characteristics, and prognostic significance of scintigraphically detected healing flare in patients with breast cancer metastatic to bone.


METHODS
Findings on bone scans and concomitant radiographs of 1,188 patients were reviewed. Bone metastases occurred in 426 patients. Outcomes of 101 patients (aged 21-71 years) with skeletal metastases were correlated with typical scintigraphic and radiographic features.


RESULTS
Healing flare with increased radiotracer uptake and radiographically demonstrated sclerotic changes in osteolytic or mixed skeletal metastases were prospectively identified in 12% of patients with skeletal metastases. Healing flare was detected 3.2 months +/- 1.4 after initiation of hormonal treatment or chemotherapy. Skeletal metastatic activity stabilized on bone scans within 6.2 months +/- 3.0. Patients with healing flare did not survive longer than patients without healing flare but with stable metastases after treatment (3.3 years +/- 2.0 vs 3.9 years +/- 1.6).


CONCLUSIONS
Scintigraphically detected healing flare represents a favorable response to therapy not associated with increased survival.
Janicek
M J
MJ
Department of Radiology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
Hayes
D F
DF
Kaplan
W D
WD
D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000628:therapy; D001842:Bone and Bones / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012189:Retrospective Studies