The "mirror" of breast cancer bone metastasis - how much do bone scans know?

Friend Minor A

Do the sisters in the group have bone metastasis, I have bone headaches these days, I suspect that the bones have turned, and I want to consult.

Patient B

@Little A do a bone scan to see, you know.

several days later

I did a bone scan and said that the ribs had a dense shadow of the ribs, was it bone metastasis?

In this case, you also need to do a full body examination to determine the condition, and it is recommended that you consult a doctor.

The above are two conversations that Xiaobian saw when lurking in our breast cancer friends group.

Many patients will wonder, what is the bone scan that Little B said? Why do I say it's a "mirror" for breast cancer bone metastasis? Today we will take a plate, what exactly is the bone scan.

First, what is bone scanning

Bone scan is actually a common name for bone imaging throughout the body, and its full name is bone radionuclide imaging (bone ECT), which is a test used to determine bone metastases. It can find bone metastases, what is the principle?

When doing bone scanning, it is necessary to inject a radioisotope imaging agent into the human blood, and the imaging agent will only accumulate at the site of bone destruction, so when imaging, the bone destruction site will show obvious differences from the normal part, so we will find it.

Bone scan has the advantages of high sensitivity, early detection, and easy missed diagnosis. This is also the reason why The patient Xiao B recommends Xiao A to do bone scan examination. But why does Little B still recommend a full body examination?

This is because bone scans are less specific, it is not easy to distinguish between osteogenesis and osteolytic lesions, and the degree of bone destruction cannot be shown, so bone scans are often used for the initial screening of bone metastases in breast cancer, and to confirm bone metastases, X-rays, CT and MRI are also required.

Second, when to do a bone scan

Bone scans are more appropriate as an initial screening for bone metastases in breast cancer, or they can be used selectively for routine staging in breast cancer patients, specifically, we may do a bone scan in the following cases:

1. Bone pain or soreness occurs in a specific area

2. Elevated alkaline phosphatase, elevated lactate dehydrogenase

3. Elevated tumor markers (such as CEA, CA153, etc.)

4. Hypercalcemia appears

5. Breast cancer patients with a stage higher than T3N1M0 are examined for staging

3. Frequently asked questions about bone scanning

Q: What is the process of doing bone imaging?

A: (1) Intravenous imaging agent;

(2) Waiting: The time to wait for the examination is about 2 to 4h, during which it is necessary to drink more water and urinate more to promote the distribution and metabolism of the imaging agent;

(3) Inspection: During the inspection, lie flat in the instrument for about 15 minutes and wait for the inspection to be completed. If bone pain or other factors are present and it is not possible to lie flat, medications may be used in advance for pain relief or symptomatic management.

Q: Does bone imaging cause radiation?

A: The radiation caused by bone imaging mainly comes from the imaging agent, but its radiation is very weak, the impact on the human body is small, and most of the imaging agent can be excreted through the urine within a few hours, so there is no need to worry too much.

It should be noted that the residual substances in the body take about two days to fully metabolize, so within two days after the examination, it is necessary to avoid close contact with people such as infants and pregnant women, and also to avoid staying in crowded public places.

Q: Can pregnant women have a bone scan?

A: Although the radiation caused by bone scan is small, pregnant women, women who may be pregnant and other more sensitive people need to clearly inform their own situation before examination, and conduct examination under the guidance of doctors.

Q: Are there any precautions when doing a bone scan?

A: (1) Bone scans do not require holding urine or fasting before the examination, and can be treated normally in the hospital, but if other tests have been done recently (such as gastrointestinal barium meal examinations, etc.), you need to inform the doctor in advance.

(2) During the period of waiting for examination after injection of imaging agent, it is necessary to drink more water, urinate more, and metabolize the excess imaging agent, which is conducive to clearly distinguishing the possible bone destruction foci.

(3) When urinating, care should be taken not to let the urine contaminate the pants and other parts of the body, so as not to affect the final result of the imaging agent in the urine.

(4) Before the examination, it is necessary to urinate again, and emptying the bladder is conducive to the examination of the pelvic bone.

(5) During the inspection, it is necessary to remove the metal items carried, such as metal belt buckles, jewelry, and mobile phones and watches.

In addition, bone scans are not currently routine and do not require regular bone scans. However, if our body is abnormal, or there is a risk of bone metastasis, we still need to follow the doctor's instructions and actively carry out the examination under the guidance of the doctor

END