Evaluation of Bone Scan in Preoperative Clinical Staging of Breast Cancer

Skeletal Scintigraphy and Physical Examination in the Staging of Early Breast Cancer

“…In agreement with other authors (3,12,14,17,21) we found a low specificity (87.7%). Considering the very small number of true positive scans and the low specificity of the test we do not regard bone scanning as a useful test for routine screening of stage 1-11 breast cancer.…”

“…In the present material there was no statistically significant difference between the prevalence of positive scans in women with or without axillary node involvement in agreement with some reports (8, 9) but in disagreement with others (11, 15). The prevalence was higher in postmenopausal patients than in premenopausal ones as previously reported by some authors (3,8,21). This can be explained by frequent pathologic conditions in older age, which cause increased tracer uptake.…”

“…This variation can, at least partly, be explained by differences in clinical staging, prevalence of nodal involvement, time between operation and performance of the scan and criteria for evaluation of the test (18,21,22). Our prevalence of 13.7% was higher than reported by most authors (1,8,14,17,21), which can be explained by our definition of a positive scan. Wide criteria for definition of a positive scan cause a high rate of false positive tests.…”

“…Furthermore it has not been demonstrated that treatment of asymptomatic metastases improves survival and quality of life (7,17,22). Initial scanning could possibly be of value as a baseline for serial scanning, but the number of asymptomatic bone metastases detected with bone scanning during follow-up is low (8,18,20,21).…”

Rastreamento de metástases no pré-operatório do câncer de mama

“…Enfatizam que, assim, evitariam a mastectomia nas pacientes com M, situação em que essa opção terapêutica é menos indicada como forma curativa. Outros autores questionam e não realizam esse rastreio na ausência de sintomatologia sugestiva de doença sistêmica ou no Ec I e II 1,3,5,6,8,20,21 . Adotam essa conduta pois a freqüência de M identificadas nesses estádios é pequena, não justificando seu rastreio indiscriminado em função dos custos elevados.…”