The distribution of bone metastases as shown on isotope scanning: proposed modes of spread

Bone metastases may result from arterial, retrograde venous or direct spread. Three groups of patients; with carcinoma of lung, carcinoma of breast and carcinoma of prostate, each of approximately 50 individuals were studied to examine patterns of spread in order to relate this to the mechanism of seeding. Statistically significant differences (p less than 0.05) were observed in early bone spread in carcinoma of prostate (absence of skull involvement), carcinoma of lung (presence of posterior chest wall involvement) and carcinoma of breast (presence of anterior chest wall involvement). The results support retrograde venous reflux as being an important contributing mode of spread for carcinoma of prostate and local spread as being relevant in the early spread of carcinoma of lung and breast.