I watched this video previously but watched it again just now because my oncologist ordered a bone scan for me on Tuesday. My ALP is 194 and climbing. Your video helped answer some questions. Thank you, Dr. Griggs.
I had a double mastectomy back in September. Today my oncologist made an appointment for me to have a bone scan due to my leg constantly hurts. It's been like that for awhile.
Cancer that spreads from Brest to Bone is unfortunately common but my understanding is the best place for it to spread to is bone It’s not curable but treatment options exist and continue to improve side effects can be woeful but what do you rather constant bone pain walking or dealing with side effects which can come and go Talk to your care team listen to your oncologist many live long after mbc diagnosis and unfortunately some don’t they do take your overall health picture into consideration also Letrozole is usually drug used for mbc and perhaps tamoxifen after bc treatment being kept under surveillance truth is after bc your always on alert for a return recurrence or mets it sucks ! Don’t give up hope there is new trends emerging in the cancer world to potentially eradicate this disease it may be years away yet and it’s a complex illness that no size fits all the unfortunate reality is without treatment you would pass away so if dealing with mbc the best way of looking at it is like chronic illness ❤ stay strong
Thanks for writing. Yes, everyone is different. There are many treatments for cancer that has spread to the bone. In general, the life expectancy is longer in people whose metastatic disease is confined to the bone. We do not, however, want people to feel like they have a "best" metastatic cancer or for others to feel they have a "worst" metastatic cancer. Like you say, everyone has their own journey.
Hello, I’m stage 3 breast cancer patient. I had mastectomy, radiation and done with chemo on March 2022. I didn’t have bone scan after the chemo treat. How does the doctor know if the cancer is gone or the treatment is working or not? Shouldn’t I have to get another bone scan?
Great question. Bone scans are important before starting chemotherapy to determine whether or not the cancer has already spread before giving chemotherapy. If the bone scan shows that the cancer was in the bone, but purpose of treatment would have been to control symptoms and extend life. If the bone scan was negative, that means that the goal of treatment was cure. Follow up tests are not useful after treatment unless someone has symptoms. Scans cannot confirm that there is no cancer. They can just confirm that there is no obvious evidence of cancer that would change the goals of care. I hope that makes sense!
Bone scans are often overused. For example, they should not be done in people with Stage 0, Stage I, or Stage II breast cancer. Even in Stage III disease, the benefit is not entirely clear.
A bone scan would be helpful if someone is having symptoms that are unclear in origin. Otherwise, people with Stage I breast cancer do not need to have bone scans.
FLARE... I just got a call. The bone scan didn't show anything on my T9, but the Pet Scan a week ago shows red. My body is clean except that T9. Now it's gone? Maybe it was just "Flare." It's BC4, and they thought it went to T9. My radiologist says she is perplexed (her words). I just randomly found this video and fast forwarded to this spot at 5:15
Thank you for writing. Your mother is fortunate to have you. At this point in medical science, we generally do not consider metastatic disease to be curable. Many people can live for many years with an excellent quality of life, however. Approximately 1 in 20 people live for 20 years. This is more often the case in people who are younger (under 50), have estrogen and progesterone receptor positive disease, and who have only bone metastases.
Thank you for writing and asking such an important question. While a cure for Stage IV (4) breast cancer, also called metastatic breast cancer, is challenging, there are treatment options available that can help manage the disease and improve quality of life. The specific treatment options depend on many specific features, including the hormone receptor status, HER2 status, sites and extent of disease, and the patient's so-called "functional status," which refers to what the patient is able to do on a typical day. You may find our video about treatment options for metastatic breast cancer helpful here: th-cam.com/video/RWer3rA6m00/w-d-xo.html.
If a patient with MBC gets a CAT scan every four months and has had PET scans would a DEXA scan be of any benefit? Is it only for osteoporosis? What machine does bone scans? Is it an x-ray machine? Are the pictures of the skeleton like a DEXA scan? Thank you for educating us.
It can be so confusing to have so many scans. A DEXA scan is only for assessing body composition, including bone mass. It does not help determine where cancer is in the bone (if at all). Bone scans require an injection of a radioisotope and then pictures 3 hours later. If the other scans are informative, not everyone needs a bone scan.
Hi mam my mother had completed her chemotherapy for breast cancer a month ago and now she is getting swelling on her face and eyes is this late side effects of chemotherapy or what please reply??
Thanks for writing. Swelling around the eyes and of the face is not a common side effect of chemotherapy, either early or late. I recommend reaching out to your mother's medical team. She's fortunate to have you.
Hi, my mom has completed her chemotherapy and targeted therapy for stage 2 breast cancer two months ago. We had her routine test done where the calcium came a bit high around 11.02 mg/dl and the vitamin D was low at 16.85 ng/ml, the doctor has asked us to get a bone scan done though she said its mostly due to Vitamin D deficiency. She was also having calcium supplements. Can this indicate metastasis?
While metastases could explain the high calcium, there are other common sources of high calcium, such as hyperparathyroidism. It is worth getting a thorough workup if the bone scan is negative. Thanks for the question.
My mom is on chemo now for stage 1 breast cancer, she got a bone scan and it shows a focal increased activity within the left proximal femur in the region of the lesser trochanter. What could that be? I’m so scared she don’t feel any pain in that area
Thanks for writing. Of course this is scary. When scans are done in people with Stage I (one) cancer with no symptoms, the vast majority of the time, these are what are called "incidental findings" and are not due to cancer. Wishing you both the best.
Hello. This is a very important question I would like to ask you. My mum went through surgery and now is on chemotherapy (AC T). It's Stage 2 breast cancer. But her doctor told her to get a bone scan while she was on chemo. The bone scan results showed that increased radiotracer concentrations are seen in right 9th rib posteriorly and d7 vertebra, and lastly the impressions were osteoblastic activity in those mentioned areas, suggesting skeletal metastases, need radiological correlation. Does the above statements mean that her staging will change now? and does it indicate that the cancer has metastasized? Would love a reply. Thanks in advance.
Thanks for writing. If the scans are consistent with metastases, this would be a Stage IV (4) cancer. It is likely that additional tests, including a biopsy, may be offered. Wishing you and your mother the best.
We do not recommend bone scans after treatment is completed. If you have symptoms, we would consider a bone scan if the symptoms suggest that bone involvement with cancer may be present.
Great question. A bone scan is different from an MRI. A bone scan looks only at bone turnover. An MRI can see shapes and sizes of all structures, normal and abnormal, in the area that is scanned.
I am stage 1 TNBC, more specifically TNAC, triple negative apocrine cancer. I have been having hip pain for over a 1yr. The pain fluctuates. I have also tried exercises. My oncologist suggested a bone scan. Hope I am not endangering myself with the injectable nuclear material. Do you think she is right to order a bone scan?
Hi, Thank you for the detailed video. My mother completed her Chemotherapy for Stage 2 Triple Negative Breast Cancer 2 years ago. She has been complaining intermittent pain in the body for about a month now. Previously the pain used to trigger only in the evening but now it's bit more severe and persistent. She feels the pain in the bones. As she already has arthritis in legs - Joint pain, doctor suspected that it might be Rheumatoid arthritis and suggested to get a few tests done that included RA Factor, Alkaline Phosphatase, TSH, Iron, Ferritin and Anti-CCP. All of them came negative. So doctor has suggested to get the Bone scan done. I'm worried and confused. What are your thoughts? Do you think bone scan would be helpful? Or we should go for some other scan? Maybe PET or MRI? Any insights from you will greatly help to make a decision.
In someone with pain that seems to be located in the bones, a bone scan is considered a great start. If the results are confusing and it's not possible to tell if there is cancer in the bone, another test, such as an MRI of a specific area or a PET scan may be needed.
@@yerbba Thank you for your response. So If I understand it correctly, bone scan will highlight all the areas with increased activity. i.e. hotspots. If we find such spots then MRI or PET scan of those areas would be required to confirm the findings. Is my understanding correct? Is bone scan only used for highlighting such areas? Or it can tell something in a definite manner?
You are FANTASTIC! Over the past 2.5 years your videos have helped me SO much. I will be having my first bone scan this week, and I believe I also have arthritis. If areas of my spine light up, I am worried they may biopsy those when they may merely be arthritis. Is a spinal bone biopsy dangerous/invasive? (I'm having the scan because I've been having lots of bone pain, but it might only be from Tamoxifen or psychogenic. I had a left femur xray but nothing showed up despite the pain there.) I feel the bone scan would be prudent given that my case was aggressive and complicated, but is a biopsy the only way they can tell the difference between cancer and arthritis? Thank you in advance.
It is possible that the bone scan could be sufficiently clearly consistent with metastases, but a biopsy is generally advised to confirm the tumor characteristics (ER, PR, and HER2) if possible. Bone biopsies are generally very very safe albeit uncomfortable and, in some people, painful. Nonetheless, being certain that what is seen on bone scan is indeed cancer is important in many cases. Thank you for being part of the Yerbba community!
Thank you so much your knowledge is so helpful - and the way you deliver the message is so easy to understand.
Thank you for your kind words and for watching
I watched this video previously but watched it again just now because my oncologist ordered a bone scan for me on Tuesday. My ALP is 194 and climbing. Your video helped answer some questions. Thank you, Dr. Griggs.
We're glad you found this video to be a helpful resource. Hoping for a good outcome. Thank you for being part of the Yerbba community!
@@yerbba the bone scan showed no metastasis, Praise the Lord!! ALP will be monitored.
I had a double mastectomy back in September. Today my oncologist made an appointment for me to have a bone scan due to my leg constantly hurts. It's been like that for awhile.
Wishing you the best. Sounds like your doctor is good as listening to you.
Cancer that spreads from Brest to Bone is unfortunately common but my understanding is the best place for it to spread to is bone
It’s not curable but treatment options exist and continue to improve side effects can be woeful but what do you rather constant bone pain walking or dealing with side effects which can come and go
Talk to your care team listen to your oncologist many live long after mbc diagnosis and unfortunately some don’t they do take your overall health picture into consideration also
Letrozole is usually drug used for mbc and perhaps tamoxifen after bc treatment being kept under surveillance truth is after bc your always on alert for a return recurrence or mets it sucks !
Don’t give up hope there is new trends emerging in the cancer world to potentially eradicate this disease it may be years away yet and it’s a complex illness that no size fits all the unfortunate reality is without treatment you would pass away so if dealing with mbc the best way of looking at it is like chronic illness ❤ stay strong
Thanks for writing. Yes, everyone is different. There are many treatments for cancer that has spread to the bone. In general, the life expectancy is longer in people whose metastatic disease is confined to the bone. We do not, however, want people to feel like they have a "best" metastatic cancer or for others to feel they have a "worst" metastatic cancer. Like you say, everyone has their own journey.
Always helpful thank you
Your support means a lot to us! Thank you for watching.
Thank you 💕
You're welcome, thank you for watching
You are very helpful! Thankyou so much! 😊❤
Thank you for watching. We are so glad you found this video helpful.
Hello, I’m stage 3 breast cancer patient. I had mastectomy, radiation and done with chemo on March 2022.
I didn’t have bone scan after the chemo treat. How does the doctor know if the cancer is gone or the treatment is working or not? Shouldn’t I have to get another bone scan?
Great question. Bone scans are important before starting chemotherapy to determine whether or not the cancer has already spread before giving chemotherapy. If the bone scan shows that the cancer was in the bone, but purpose of treatment would have been to control symptoms and extend life. If the bone scan was negative, that means that the goal of treatment was cure. Follow up tests are not useful after treatment unless someone has symptoms. Scans cannot confirm that there is no cancer. They can just confirm that there is no obvious evidence of cancer that would change the goals of care. I hope that makes sense!
@@yerbba
Thank you so much for your kind explanation. It makes sense
I don’t think this is done much by the NHS in the UK? Not for breast cancer.
Bone scans are often overused. For example, they should not be done in people with Stage 0, Stage I, or Stage II breast cancer. Even in Stage III disease, the benefit is not entirely clear.
Thank you for your explanation. Is there a case when person with stage 1 is still ordered for a bone scan?
A bone scan would be helpful if someone is having symptoms that are unclear in origin. Otherwise, people with Stage I breast cancer do not need to have bone scans.
FLARE... I just got a call. The bone scan didn't show anything on my T9, but the Pet Scan a week ago shows red. My body is clean except that T9. Now it's gone? Maybe it was just "Flare." It's BC4, and they thought it went to T9. My radiologist says she is perplexed (her words). I just randomly found this video and fast forwarded to this spot at 5:15
Yes, a tumor flare can happen or other things can account for a one-time finding on any type of scan. Hoping nothing pops up in this area!
Hi, please my mother suffering from bone mets,is it curable??
Thank you for writing. Your mother is fortunate to have you. At this point in medical science, we generally do not consider metastatic disease to be curable. Many people can live for many years with an excellent quality of life, however. Approximately 1 in 20 people live for 20 years. This is more often the case in people who are younger (under 50), have estrogen and progesterone receptor positive disease, and who have only bone metastases.
Mam,, breast cancer stage 4 metastatics in bone can be cured??which treatment is best???survival rate??From,,Bangladesh
Thank you for writing and asking such an important question. While a cure for Stage IV (4) breast cancer, also called metastatic breast cancer, is challenging, there are treatment options available that can help manage the disease and improve quality of life. The specific treatment options depend on many specific features, including the hormone receptor status, HER2 status, sites and extent of disease, and the patient's so-called "functional status," which refers to what the patient is able to do on a typical day. You may find our video about treatment options for metastatic breast cancer helpful here: th-cam.com/video/RWer3rA6m00/w-d-xo.html.
@@yerbba my sisters hormon positive breast cancer.. Pls,,tell me survival rate???
How much radiation is emitted from a bone scan compared with a MRI? minimal not to be concerned?
Correct, minimal exposure. Great question.
If a patient with MBC gets a CAT scan every four months and has had PET scans would a DEXA scan be of any benefit? Is it only for osteoporosis? What machine does bone scans? Is it an x-ray machine? Are the pictures of the skeleton like a DEXA scan? Thank you for educating us.
It can be so confusing to have so many scans. A DEXA scan is only for assessing body composition, including bone mass. It does not help determine where cancer is in the bone (if at all). Bone scans require an injection of a radioisotope and then pictures 3 hours later. If the other scans are informative, not everyone needs a bone scan.
"metabolic activity involving intramedullary spine"
What does this mean?
Hi mam my mother had completed her chemotherapy for breast cancer a month ago and now she is getting swelling on her face and eyes is this late side effects of chemotherapy or what please reply??
Thanks for writing. Swelling around the eyes and of the face is not a common side effect of chemotherapy, either early or late. I recommend reaching out to your mother's medical team. She's fortunate to have you.
@@yerbba thank you so much for reply
Hi, my mom has completed her chemotherapy and targeted therapy for stage 2 breast cancer two months ago. We had her routine test done where the calcium came a bit high around 11.02 mg/dl and the vitamin D was low at 16.85 ng/ml, the doctor has asked us to get a bone scan done though she said its mostly due to Vitamin D deficiency. She was also having calcium supplements. Can this indicate metastasis?
While metastases could explain the high calcium, there are other common sources of high calcium, such as hyperparathyroidism. It is worth getting a thorough workup if the bone scan is negative. Thanks for the question.
My mom is on chemo now for stage 1 breast cancer, she got a bone scan and it shows a focal increased activity within the left proximal femur in the region of the lesser trochanter. What could that be? I’m so scared she don’t feel any pain in that area
Thanks for writing. Of course this is scary. When scans are done in people with Stage I (one) cancer with no symptoms, the vast majority of the time, these are what are called "incidental findings" and are not due to cancer. Wishing you both the best.
Hello. This is a very important question I would like to ask you. My mum went through surgery and now is on chemotherapy (AC T). It's Stage 2 breast cancer. But her doctor told her to get a bone scan while she was on chemo. The bone scan results showed that increased radiotracer concentrations are seen in right 9th rib posteriorly and d7 vertebra, and lastly the impressions were osteoblastic activity in those mentioned areas, suggesting skeletal metastases, need radiological correlation.
Does the above statements mean that her staging will change now? and does it indicate that the cancer has metastasized? Would love a reply. Thanks in advance.
Thanks for writing. If the scans are consistent with metastases, this would be a Stage IV (4) cancer. It is likely that additional tests, including a biopsy, may be offered. Wishing you and your mother the best.
I am from India
I got a doubt
Is Bone Scaning is required during follow ups ( Even without any symptoms)
Regards
Vara Prasad
We do not recommend bone scans after treatment is completed. If you have symptoms, we would consider a bone scan if the symptoms suggest that bone involvement with cancer may be present.
Is a bone scan an MRI?
Great question. A bone scan is different from an MRI. A bone scan looks only at bone turnover. An MRI can see shapes and sizes of all structures, normal and abnormal, in the area that is scanned.
It's claustrophobic like an mri. even though it's open on the sides, It is really close to your face. I had a whole body one and panicked at the end
Maam! my mom has stage 1 breast cancer.she is also struggling from joints issue. So should we go for bone scan or only follow cancer treatment?
Having joint pains does not require a bone scan. Such a good question, and thank you for writing.
I am stage 1 TNBC, more specifically TNAC, triple negative apocrine cancer. I have been having hip pain for over a 1yr. The pain fluctuates. I have also tried exercises. My oncologist suggested a bone scan. Hope I am not endangering myself with the injectable nuclear material. Do you think she is right to order a bone scan?
Hi, Thank you for the detailed video. My mother completed her Chemotherapy for Stage 2 Triple Negative Breast Cancer 2 years ago.
She has been complaining intermittent pain in the body for about a month now. Previously the pain used to trigger only in the evening but now it's bit more severe and persistent. She feels the pain in the bones.
As she already has arthritis in legs - Joint pain, doctor suspected that it might be Rheumatoid arthritis and suggested to get a few tests done that included RA Factor, Alkaline Phosphatase, TSH, Iron, Ferritin and Anti-CCP. All of them came negative.
So doctor has suggested to get the Bone scan done. I'm worried and confused.
What are your thoughts?
Do you think bone scan would be helpful? Or we should go for some other scan? Maybe PET or MRI? Any insights from you will greatly help to make a decision.
In someone with pain that seems to be located in the bones, a bone scan is considered a great start. If the results are confusing and it's not possible to tell if there is cancer in the bone, another test, such as an MRI of a specific area or a PET scan may be needed.
@@yerbba Thank you for your response. So If I understand it correctly, bone scan will highlight all the areas with increased activity. i.e. hotspots.
If we find such spots then MRI or PET scan of those areas would be required to confirm the findings. Is my understanding correct? Is bone scan only used for highlighting such areas? Or it can tell something in a definite manner?
Hello doctor, is bone scan needed after whole body FDG PET-CT scan which shows negative metastasis? Thank you
In general, a PET-CT should be sufficient. If someone has worrisome symptoms, a bone scan may be part of the evaluation.
Thank you doctor for the reply.
You are FANTASTIC! Over the past 2.5 years your videos have helped me SO much. I will be having my first bone scan this week, and I believe I also have arthritis. If areas of my spine light up, I am worried they may biopsy those when they may merely be arthritis. Is a spinal bone biopsy dangerous/invasive? (I'm having the scan because I've been having lots of bone pain, but it might only be from Tamoxifen or psychogenic. I had a left femur xray but nothing showed up despite the pain there.) I feel the bone scan would be prudent given that my case was aggressive and complicated, but is a biopsy the only way they can tell the difference between cancer and arthritis? Thank you in advance.
It is possible that the bone scan could be sufficiently clearly consistent with metastases, but a biopsy is generally advised to confirm the tumor characteristics (ER, PR, and HER2) if possible. Bone biopsies are generally very very safe albeit uncomfortable and, in some people, painful. Nonetheless, being certain that what is seen on bone scan is indeed cancer is important in many cases. Thank you for being part of the Yerbba community!
@@yerbba Thank you so very much. Again, your videos are excellent.
Do we require a bone scan if you have already done a pet scan?
Great question. PET scans are quite thorough, and a bone scan will add little if anything
Tq doc Jen...👍
Always a pleasure!