Can computerised tomography replace bone scintigraphy in detecting bone metastases from breast cancer? A prospective study.
BACKGROUND
The aim of this study was to determine whether bone scans (BS) can be avoided if pelvis was included in CT thorax and abdomen to detect bony metastases from breast cancer.


METHODS
Results of 77 pairs of CT (thorax, abdomen, and pelvis) and BS in newly diagnosed patients with metastatic breast cancer (MBC) were compared prospectively for 12 months. Both scans were blindly assessed by experienced radiologists and discussed at multidisciplinary team meetings regarding the diagnosis of bone metastases.


RESULTS
CT detected metastatic bone lesions in 43 (98%) of 44 patients with bone metastases. The remaining patient had a solitary, asymptomatic bony metastasis in shaft of femur. BS was positive in all patients with bone metastases. There were 11 cases of false positive findings on BS.


CONCLUSIONS
Our findings suggest routine BS of patients presenting with MBC is not required if CT (thorax, abdomen, and pelvis) is performed.
Bristow
A R
AR
Division of Breast Surgery, University of Nottingham, UK.
Agrawal
A
A
Evans
A J
AJ
Burrell
H C
HC
Cornford
E J
EJ
James
J J
JJ
Hamilton
L
L
Robertson
J F R
JF
Chan
S Y
SY
Lawton
P A
PA
Cheung
K L
KL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010388:Pelvis / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011860:Radiography, Abdominal / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods