[Indication for bone scans in early breast cancer staging]

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• Bone scans are a common diagnostic tool for staging breast cancer.
• The effectiveness of bone scans in early-stage disease requires evaluation to optimize clinical practice.

Purpose of the Study:

• To evaluate the necessity of bone scanning in the staging of early breast cancer.
• To assess if current practices regarding bone scanning in early breast cancer need modification due to limited effectiveness.

Main Methods:

• Retrospective review of bone scans performed in 2007 for primary breast cancer patients.
• Analysis of bone scan results correlated with clinical and histopathologic tumor characteristics.
• Stratification of T2 tumors by size (3 cm) and clinical stage.

Main Results:

• 97% of bone scans were negative for metastatic disease.
• No bone metastases were found in patients with Tis and T1 lesions (<2 cm).
• Bone metastases were detected in 3.6% of T2 lesions (>2 cm and 3 cm).
• Bone scans did not alter staging for T2, stage IIA patients, but did for 2 of 12 T2, stage IIB patients.
• Bone metastases were found in 20% of T3 and 13% of T4 tumors.

Conclusions:

• Bone scanning is not indicated for early breast cancer (Tis, T1, and T2 tumors
• Pre-treatment bone scanning remains indicated for T2 stage IIB, T3, and T4 breast cancer.
• Modifying current practices by limiting bone scans in specific early-stage breast cancer populations is recommended.