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History of breast cancer. Nuclear medicine bone scan was performed following injection? Suggest

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Practicing since : 2004
Answered : 1210 Questions
Hi Dr. Grief,

I have a history of Breast cancer (right), lumpectomy in 2007, followed by chemo and radiation.

I had a (SMH) XNBNTWOS - BONCE SCAN TOTAL W/O SPECT. Nuclear medicine bone scan was performed following injection of 25.4m Ci Tc labeld HDP.

There is mildly increased tracer activity involving the distal ends of the right 4th, 6th and 7th ribs and left 6th rib. This is nonspecific. There is increased tracer activity in the region of the sternoclavicular joints bilaterally and right shoulder which probably is denerative in nature. There is increased tracer activity involving both knees and both first MTP joints most likely degenerative in nature. Renal activity is seen.

IMPRESSION: Mildly increased tracer activity involving the anterior ribs, right greater than left. This is nonspecific. Further evaluation could be performed with PET/CT to assess hypermetabolic activity. Followup bone scan could be performed in 3 months to assess for stability.

Can you explain in simple words, please? Something I have to worry about?
Posted Sun, 9 Jun 2013 in Cancer
Answered by Dr. Indranil Ghosh 8 hours later
Thanks for your query. First of all I would like to know why this bone scan was done? were there any symptoms or just as a routine follow-up? I would like to inform you that routine follow-up bone scans are recommended against by American Society of Clinical Oncology (ASCO). This is because these scans don't help.

To come back to the report you had, I would consider it all unrelated to cancer unless there are specific symptoms at the ribs. I won't go for PET-CT scan or any other further investigations.

I believe you will do just fine.

Hope I have answered your query. I will be available to answer further follow-up queries, if any.
Above answer was peer-reviewed by
Follow-up: History of breast cancer. Nuclear medicine bone scan was performed following injection? Suggest 10 hours later
Good morning Dr. XXXXXXX

Thank you for your prompt reply. After the use of FEMARA, I had all the anticipated side effects, back pain, joint pain, sort of spasms, therefore, I was switched to Anastrazole. The symptoms reduced in 95%. The Doctor asked me if we had had any imagery, and that is how it came about. She also informed me that PET-CT scans are not recommended.

The only discomfort I have in my ribs, is where the bra line is. I guess I need to get a larger size. However, back in 2008, after the radiation therapy was over, I had a frozen shoulder (right). I had an X-Ray and an MRI. The same radiologyst reported both. The X-Ray indicated that there was a neoplastic activity in the right spacula, recommending an MRI. The MRI discarded any metastasis. That's the only thing that would be of some concern. As to my right shoulder blade, I was born with a funny one, it is not flat as the other, it is kind of pointy on the lower part, my left profile differs from my right profile. Also, after the lumpectomy when they asked me how I felt as I was waking up, I complained about the right sholder blade. It is sort of pointy, and when they operated on me, I assume they put pressure on it.

Finally, the report that I sent you also says Renal Activity. As far as I am concerned, my last lab tests two months ago showed normal renal activity.

Thank you for your input, I will keep it in mind. I feel good, no strange pain, other than bonions, discomfort under the bra line, a bit of stiff back, knees when I kneel down, I cannot do it, even on a cushioned surface.


Answered by Dr. Indranil Ghosh 18 minutes later
Thanks for followup.
So you don't have any symptoms of concern. Hence i would just follow you clinically. The renal activity is normally seen on bone scans. This is not to be worried about.
Best wishes.
Above answer was peer-reviewed by
Follow-up: History of breast cancer. Nuclear medicine bone scan was performed following injection? Suggest 1 hour later
Many thanks, Dr. Ghos.
Best regards,
Answered by Dr. Indranil Ghosh 10 minutes later
You are most welcome.
Above answer was peer-reviewed by
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