Role of preoperative bone scan in carcinoma of the breast

The spread of carcinoma of the breast beyond the mammary tissue and regional lymph nodes most commonly occurs in the axial skeleton. The results of several investigations have shown that scintiscans are more accurate and sensitive than radiographs for the early detection of metastases to the bone. In recent years, bone seeking radionuclides, such as 87Sr, 87/sup mr/Sr and 18F, have been used for skeletal imaging. Currently, 99/sup m/Tc polyphosphate is the agent most widely used, since it is readily available, easy to produce and, because it has a high yield of monoenergetic gamma emissions, can be used with either a gamma camera or a rectilinear scanner. Because of the safety and the relative ease with which a bone scan can be obtained, many investigators have advocated its routine use prior to radical mastectomy. In recent years, a number of investigators have reported a relatively high incidence of abnormal postoperative bone scans in patients who had carcinoma of the breast. This prospective study was undertaken to evaluate the yield of positive scan results in a group of unselected patients with carcinoma of the breast, according to the size of the primary tumor