The Role of Whole Body Scan and Skeletal Radiography in the Preoperative Staging of Breast Cancer

Abstract
442 patients with breast cancer were studied by means of radiologic and scintigraphic examination of the skeleton to detect the presence of bone metastases. All the patients have been clinically followed-up for a mean periode of 22 months. The overall prevalence of bone metastases at staging was 4.5 %. Bone scan showed a higher sensitivity in detecting bone metastases (90 % vs 45 %) and a lower positive predictive value (60 % vs 75 %) with respect to X-ray examination. In the present series no asymptomatic case with bone metastases was found in limited stages (T1-T2 N0-N1). The authors suggest that the bone scan be routinely included in the staging of advanced breast cancer cases and that the use of this procedure be restricted to the symptomatic patients in the more limited stages.