A Solitary Bone Lesion in a Patient With Previous Breast Cancer and the Importance of Bone Biopsy: A Case Report and a Review of Guidelines

Abstract

Introduction Increased radionuclide bone scan uptake in a solitary bony site in patients with known malignancy are common and can be a diagostic problem, given the nonspecificity of bone scintigraphy. Bone s the most common site of metastatic breast cancer recurrence, and approximately 80% of patients with metastatic disease have bone metastases. Bony lesions are usually, but by no means always, ultiple, and, in one study, 98% of solitary bone lesions suspected of eing metastatic subsequently proved to be so. Other investigations, including, in particular, magnetic resonance imaging (MRI) can add to the diagnostic accuracy of isotopic bone scanning, but the definitive diagnosis would be with histologic material obtained at bone biopsy. However, bone biopsy is by no means a routine procedure. Imaging-guided bone biopsy is generally a low-risk procedure, but possible adverse effects range from minor (pain and minor damage to surrounding tissue) to major (localized infection, osteomyelitis, par-