Hamaoka et al developed an algorithm for using different imaging studies to identify bone lesions of metastatic breast cancer. The authors are from the M.D. Anderson Cancer Center in Houston.
Initial screening:
(1) symptoms of metastatic cancer to bone
(2) findings of skeletal scintigraphy
|
Symptoms |
Skeletal Scintigraphy |
Assessment |
|
none |
negative or non-metastatic lesions |
negative for metastatic cancer |
|
present |
negative or non-metastatic lesions |
perform plain X-ray |
|
present |
positive (multiple, solitary, diffuse, atypical) |
perform plain X-ray |
|
Finding on Plain X-ray |
Assessment |
|
positive |
metastatic carcinoma present |
|
negative or show benign lesion |
negative for metastatic carcinoma |
|
suspicious or continued clinical suspicion |
perform CT or MRI |
CT scan may be preferred for:
(1) weight-bearing bones (lower extremity, pelvis)
(2) ribs and sternum
MRI may be preferred for vertebrae.
Bone biopsy may be used if:
(1) the CT or MRI scan are indeterminate
(2) need confirmation of the diagnosis
Baseline plain X-rays, CT and MRI scans should be performed in patients with metastatic cancer prior to therapy. These can be useful for later reference and for monitoring bone density.
Purpose: To evaluate a patient with breast cancer for metastatic bone lesions using imaging studies based on the study of Hamaoka et al.
Specialty: Hematology Oncology, Surgery, general
Objective: options, selection
ICD-10: C79.5,
