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AN ANALYSIS OF BONE SCINTIGRAPHY IN EARLY (OPERABLE) BREAST CANCER
Author(s) -
Kitchen Pual R. B.,
Andrews John T.,
Buckley Jonathan D.,
Russell Ian s.,
Lichtenstein Meir,
McLean Katrina,
Forbes John F.
Publication year - 1979
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1979.tb07671.x
Subject(s) - medicine , breast cancer , axillary lymph nodes , radiology , bone scintigraphy , scintigraphy , lymph , cancer , nuclear medicine , pathology
A retrospecitve review of the results of boen scintigrams (scans), perfromed on 85 consecutive patients with operable breast cancer at the Royal Melbourne Hospital, revealed a true positive scan rate of 10%. No significant association was found between positive scans and either tumour size or clinical status of axillary nodes; however, a statistically significant association was demonstrated between positive scans and the presence of pathologically involved axillary nodes. Scans were positive in nine out of 54 patients (17%) with involved nodes and in eight out of 21 (38%) with four or more involved nodes, but in none out of 24 patients with negative nodes. ( P is less than 0.05). Of the 85 patients, 29 had scans showing increased uptake; 13 of these had benign disease demonstrated radiologically, and technical or reporting error accounted for another seven. This left nine true positives. Clinical metastases subsequently developed in eight of the nine scan‐positive patients (89%), but in only 17 of the 76 scan‐negative patients (22%), within the follow‐up period (mean 16 months). ( P is less than 0.0005.) Seven of the eight scan‐positive patients who developed clinically obvious metastases had four or more involved axillary lymph nodes. It is concluded that the finding of an unequivocally positive bone scan in a patient with clinically “early” breast cancer strongly suggests the presence of metastases and must be considered in planning appropriate treatment. Furthermore, although the bone scan is unlikely to be positive if nodes are histologically negative, it can be an important staging investigation and prognostic index for patients who are found to be node‐positive, especially if a large number of lymph nodes are involved.