Role of preoperative bone scan in carcinoma of the breast

Although a skeletal scan is an effective means of detecting early metastatic deposits from carcinoma of the breast, its indiscriminate use in screening patients with early tumors does not seem justified because of the low yield of abnormal results. Selection of patients for this procedure should be based on the size of the tumor and the clinical stage of the disease. It is extremely unlikely that patients with a T1 lesion will have an abnormal skeletal scan. A preoperative scan in indicated for T2 lesions in patients with a central or medial quadrant mass, inflammatory carcinoma, palpable axillary lymph nodes or other clinical evidence suggestive of spread beyond breast tissue. All patients with T3 and inoperable tumors should have a bone scan prior to therapy to define the extent of the disease. A routine postoperative scan at six month intervals may be considered only in patients with large primary lesions and involvement of regional lymph nodes.