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Forum Name: Breast Cancer

Question: Why is a bone scan ordered in breast cancer survivor?


 kermane - Thu Feb 28, 2008 7:09 pm

I am a 4 year(in August) survivor of Stage II breast cancer in the right breast, 12 lymph nodes removed, none positive for cancer, had left breast removed 4 months after right breast, no cancer in it.

I recently switched oncologist, due to the other office switching me 4x to 4 different doctors, the last one who did not listen to my opinion at all. Last bloodwork done by them in September of last year.

The new one did bloodwork, about 7 tubes, ct scan of abdomen, chest xray, ultrasound of reconstructed breasts. I came home to a message that they had my bloodwork results and wanted to schedule a bone scan.

A little background, I have Cowden disorder, I produce no calcium after my thyroid was removed, I have to take 16 calcium pills a day since I produce none.

Why would she order a bone scan? Can something show in my bloodwork that would make her think bone cancer?
 Dr. Chan Lowe - Fri Feb 29, 2008 3:45 pm

User avatar Hi Kermane,

Cancers can spread to the bone and a bone scan is a method to evaluate the whole skeleton at one time to see if there are any concerning areas that should be evaluated further. It may be that your new oncologist is wanting to simply go over all the bases since you are a new patient.

I would recommend you talk with your oncologist to see if there was something concerning or if it is simply a screening test.

Best wishes.
 Dr. Tamer Fouad - Fri Feb 29, 2008 4:28 pm

User avatar Hello Kermane,

I agree with Dr. Chan. Sometimes your blood work includes a test called tumor markers (e.g. CA-15.3 and CA 19.9). Let me say that these tests are neither sensitive nor specific for breast cancer. Ideally we would do these tests and be able to diagnose whether a patient has cancer or not but that has never been the case since these tests are very imprecise. Currently their only indication seems to be the follow up patients that have already been diagnosed as having advanced disease and are receiving treatment for it.

Assuming that's what was done, it may be that one of these tests was elevated and like Dr. Chan mentioned your doctor thought it was a good idea to cover all the bases. In fact that's exactly what your doctor is doing because he seems to have ordered a CT scan of the abdomen, a chest x-ray and an ultrasound all of which are not currently indicated in the routine follow up of breast cancer survivors who are cured and have no symptoms.

Please keep this thread updated.

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