The radionuclide bone scan in breast cancer

Radionuclide bone imaging using technetium Tc 99m labeled methylene diphosphonate has become an integral part of the management of various cancers, including breast cancer, since the early 1970s. In spite of this long clinical experience, the precise role of bone scans in the management of breast cancer has changed somewhat. The examination will have its greatest screening value in the higher stages of disease where the likelihood of metastatic disease is greater. The efficacy of performing routine bone scintigraphy in more limited, lower stage tumors is not established. In patients with solitary radiographic abnormalities, the bone scan will not only establish whether the lesion is metabolically active but will also determine whether additional, unsuspected lesions are present. One of its greatest assets is the ability to perform serial studies to easily monitor patients with metastatic breast cancer.