Detection of bone metastases in routine follow-up after treatment for primary breast cancer

Single cells from mammary carcinoma infiltrating bone marrow can be detected in marrow aspirates using immunocytochemical stains for epithelial membrane antigen (EMA). This technique has been used to examine marrow aspirates taken from multiple sites from 24 patients at surgery for breast cancer. Ten of these patients had EMA-positive cells in their marrow, while 32 marrow samples from patients who did not have carcinoma were negative. These results have been combined with those obtained by taking aspirates from single sites from 47 breast patients without known skeletal deposits. Follow up showed that the patients with EMA-positive cells in their marrow developed bone metastases at a significantly faster rate.

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Faculty Opinions recommendation of Adjuvant oral clodronate improves the overall survival of primary breast cancer patients with micrometastases to the bone marrow: a long-term follow-up.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1145093.602227 ◽

2009 ◽

Author(s):

Gilberto Schwartsmann ◽

Fabio Leal

Keyword(s):

Breast Cancer ◽

Bone Marrow ◽

Overall Survival ◽

Cancer Patients ◽

Primary Breast Cancer ◽

Breast Cancer Patients ◽

Long Term Follow Up ◽

Oral Clodronate

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PO139 RECEPTOR ACTIVATOR OF NUCLEAR FACTOR KAPPA B (RANK) EXPRESSION IN PRIMARY BREAST CANCER CORRELATES WITH RECURRENCE FREE SURVIVAL AND DEVELOPMENT OF BONE METASTASES IN THE I-SPY 1 TRIAL (CALGB 150007/150012; ACRIN 6657)

The Breast ◽

10.1016/s0960-9776(15)30151-x ◽

2015 ◽

Vol 24 ◽

pp. S69-S70

Author(s):

Neelima Vidula ◽

Christina Yau ◽

Jiali Li ◽

Hope S. Rugo

Keyword(s):

Breast Cancer ◽

Bone Metastases ◽

Primary Breast Cancer ◽

Nuclear Factor Kappa B ◽

Nuclear Factor ◽

Recurrence Free Survival ◽

Free Survival ◽

Nuclear Factor Kappa ◽

Receptor Activator ◽

Survival And Development

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Prospective comparison of the diagnostic accuracy of 18F-FDG PET/MRI, MRI, CT, and bone scintigraphy for the detection of bone metastases in the initial staging of primary breast cancer patients

European Radiology ◽

10.1007/s00330-021-07956-0 ◽

2021 ◽

Author(s):

Nils Martin Bruckmann ◽

Julian Kirchner ◽

Lale Umutlu ◽

Wolfgang Peter Fendler ◽

Robert Seifert ◽

...

Keyword(s):

Breast Cancer ◽

Bone Metastases ◽

Cancer Patients ◽

Bone Scintigraphy ◽

Fdg Pet ◽

Primary Breast Cancer ◽

Whole Body ◽

Newly Diagnosed ◽

Breast Cancer Patients ◽

Initial Staging

Abstract Objectives To compare the diagnostic performance of [18F]FDG PET/MRI, MRI, CT, and bone scintigraphy for the detection of bone metastases in the initial staging of primary breast cancer patients. Material and methods A cohort of 154 therapy-naive patients with newly diagnosed, histopathologically proven breast cancer was enrolled in this study prospectively. All patients underwent a whole-body [18F]FDG PET/MRI, computed tomography (CT) scan, and a bone scintigraphy prior to therapy. All datasets were evaluated regarding the presence of bone metastases. McNemar χ2 test was performed to compare sensitivity and specificity between the modalities. Results Forty-one bone metastases were present in 7/154 patients (4.5%). Both [18F]FDG PET/MRI and MRI alone were able to detect all of the patients with histopathologically proven bone metastases (sensitivity 100%; specificity 100%) and did not miss any of the 41 malignant lesions (sensitivity 100%). CT detected 5/7 patients (sensitivity 71.4%; specificity 98.6%) and 23/41 lesions (sensitivity 56.1%). Bone scintigraphy detected only 2/7 patients (sensitivity 28.6%) and 15/41 lesions (sensitivity 36.6%). Furthermore, CT and scintigraphy led to false-positive findings of bone metastases in 2 patients and in 1 patient, respectively. The sensitivity of PET/MRI and MRI alone was significantly better compared with CT (p < 0.01, difference 43.9%) and bone scintigraphy (p < 0.01, difference 63.4%). Conclusion [18F]FDG PET/MRI and MRI are significantly better than CT or bone scintigraphy for the detection of bone metastases in patients with newly diagnosed breast cancer. Both CT and bone scintigraphy show a substantially limited sensitivity in detection of bone metastases. Key Points • [18F]FDG PET/MRI and MRI alone are significantly superior to CT and bone scintigraphy for the detection of bone metastases in patients with newly diagnosed breast cancer. • Radiation-free whole-body MRI might serve as modality of choice in detection of bone metastases in breast cancer patients.

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