Value of baseline and follow-up whole-body bone scans in detecting bone metastasis in high-risk breast cancer patients

Abstract

The aim of the study was to test the value of routine baseline and follow-up bone scans in societies with a prevalence of high-risk breast cancer features. The medical records of 261 Jordanian breast cancer patients were reviewed. Patients who had (a) breast cancer proven by pathology, (b) had undergone a baseline bone scan, and (c) had undergone follow-up bone scan(s) for at least 12 months were included in the study. The patients were divided into three groups. Group 1 included 171 patients who had negative bone scans; group 2 included 52 patients who had negative baseline bone scans but developed bone metastasis on follow-up; and group 3 included 38 patients who had bone metastasis at presentation. Patients' ages ranged between 21 and 85 years with mean ± SD of 49.7 (± 11.3) years. About 55% of our patients were younger than 50 years. Clinicopathological stages were as follows: 14% of patients were in stage I, 42% were in stage II, 30% were in stage III, and 14% were in stage IV. A significant proportion of our patients have high-risk features. Fourteen percent of the patients already had bone metastasis at diagnosis and 20% developed bone metastasis on follow-up. Sixty percent of group 2 patients developed bone metastasis within 2 years after diagnosis and the rest (40%) developed bone metastasis 2 years after diagnosis (≤ 13 years). Within the limitations of this retrospective study, in a country like Jordan with greater prevalence of high-risk breast cancer features, a routine baseline whole-body bone scan might be justifiable. Follow-up whole-body bone scans might result in better quality of life and lower skeletal-related morbidity. Further prospective work is suggested.