Value of preoperative radionuclide bone scan in suspected primary breast carcinoma

The value of radionuclide bone scanning performed before "curative" surgery in 100 female patients with suspected (91 patients) or known (9 patients) carcinoma of the breast was assessed. Limitations of the bone scan in this patient population were (1) a weak relationship between scan abnormalities and pathologic stage of the primary breast cancer, (2) a high incidence of equivocal scans, and (3) a low incidence of definite scan abnormalities which could not be accounted for by benign osseous disorders. The limited value of preoperative bone scanning in this study may be a result of the high proportion of patients with favorable breast lesions, who would be expected to have a low incidence of bone metastases at the time of primary surgical therapy. Guidelines for the use of bone scanning in the management of primary carcinoma of the breast are discussed.