Abstract
The most common site of metastases from breast cancer is the skeleton. Conventional methods of detecting skeletal metastases are not very sensitive. Substantial evidence indicates that skeletal scintigraphy is the most accurate method of demonstrating metastases to bone, particularly in patients with “early” breast cancer who have no manifestations of metastatic disease. In a study of 50 patients with advanced mammary carcinoma, skeletal metastases were demonstrated by scintigram (and later confirmed) in 84%, but by conventional x-rays in only 50%. More important, in 50 patients with “early” breast cancer who had negative skeletal x-rays, lesions were found by scintigraphy in 24%. All of these patients developed disseminated carcinoma and 83% of them died within 5 years. In contrast, only 34% of patients with a negative scintigram developed disseminated carcinoma within 5 years.
Résumé
Le cancer du sein métastasie le plus souvent dans le squelette. Les méthodes conventionnelles de détection des métastases osseuses ne sont pas très sensibles. La scintigraphie est la méthode de détection la plus précise, surtout pour les patientes porteuses d'un cancer du sein “débutant” sans symptomes de métastases. On a pu démontrer par scintigraphie des métastases squelettiques (qui furent confirmées plus tard) chez 84% de 50 malades atteintes de carcinome mammaire au stade avancé, alors que la radiographie conventionnelle n'avait démontré des lésions osseuses que dans 50% des cas. De plus, la scintigraphie a permis de découvrir 24% des métastases dans une série de 50 malades atteintes d'un cancer mammaire “débutant” et dont les radiographies du squelette étaient normales. Toutes ces patientes présentèrent des signes de dissémination cancéreuse et 83% d'entre elles sont mortes endéans les 5 ans. A l'opposé, 34% seulement des malades avec scintigraphie normale développèrent des signes de généralisation au cours des 5 années du follow-up.
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Galasko, C.S.B. The role of skeletal scintigraphy in detection of metastatic breast cancer. World J. Surg. 1, 295–298 (1977). https://doi.org/10.1007/BF01556841
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DOI: https://doi.org/10.1007/BF01556841