Bone scanning: Its value in the preoperative evaluation of patients with suspicious breast masses

Postoperative evaluation of one hundred sixty-four patients with carcinoma of the breast was obtained by bone scans, utilizing 87 m strontium and a rectilinear scanner. Sixty patients were seen within three months of their operation, and forty-seven of these were considered to have early breast cancer (pathologic stages I and II). All were asymptomatic and most had negative findings on roentgenogram. Nineteen of these forty-seven patients (40 per cent) had abnormal results on study consistent with metastatic disease. Subsequent proof was obtained in sixteen cases, by bone biopsy, autopsy, or changes on roentgenograms. Another forty-seven patients were studied because of local recurrent or regional disease. Twenty-three of these forty-seven patients (49 per cent) had evidence of distal disease seen on bone scan, bone survey, or chest roentgenograms. The bone scan, which has been proved to be a more sensitive indicator of bone disease than is conventional roentgenography, should be employed prior to any contemplated radical surgery in presumed early breast cancer. Detection of unsuspected metastatic bone disease should then provide a more rational approach to therapy.