[Staging of patients with carcinoma of the breast by bone scans? [author's transl)]

Bone scans were performed in 170 patients with widespread breast cancer and metastases which were confirmed by the clinical course. In 82% a positive x-ray and in 95% a positive bone scan could be demonstrated. In 43 patients without bone metastases the ratio of false positive scans was 5%. Seventeen out of 50 patients with early cancer had abnormal scans. In 12 cases there were metastases proven by follow-up of at least 18 months. Assuming an incidence of 25% for bone metastases in patients with early breast cancer, bone scans with a sensitivity and specificity of 95% will be valid in staging. To validate this high incidence we investigated a second group of 97 patients with early cancer in a prospective study: in only 3 cases there was an abnormal scan. Using this low incidence bone scanning is calculated to be not valid for staging of breast cancer.