Different results from scans

AC40

I am 34 years old and was diagnosed with breast cancer last year March. I immediately underwent a double mastectomy, chemo and radiation. I completed my treatment in January 2015. I underwent a PET scan in March 2015 that indicated that the cancer spread to my hips and spine. To confirm the diagnosis, I went for a Bone scan a week later. The bone scan was completely clean with no areas of concern. I now went for a MRI that indicated various areas of concern in my spine. The report however indicates that the result should be confirmed with a Bone scan. I am young, did all the required treatments and actually feel fine. Could the lesions on the bones be something different or is it mets? I am very confused and worried. Does anyone have a similar experience?

GoldenGirls

I am sorry that you are dealing with this.

My mother had a similar experience after over a decade since her original diagnosis. A CT scan found many suspicious areas, a bone scan had different findings and then she endured 2 negative bone biopsies before the third finally confirmed it. The way it was explained to us is that different types of bone mets show up differently on each scan. Some are better at detecting lytic lesions while others are better with osteoblastic lesions.

A bone scan can show uptake from degeneration or injury and it might/might not show mets depending on the type and size, but if your PET and MRI show mets, then it's very likely that there are mets. After two negative biopsies and differing scan results, her onc (who is amazing) was ready to start treatment for mets regardless of what the third biopsy showed. When I asked why, he said "If it looks like a duck and walks like a duck..." Basically that the scans made it quite clear that there were mets and the biopsy was really just to check to see if her ER/PR, etc was still the same as her original diagnosis. Most oncologists will make a bone mets diganosis based on PET, CT, and MRI even without biopsy. Multiple areas and a previous cancer diagnosis make mets the first on the list of differential diagnosis over arthritis, injury, and other possible causes.

Are you getting a biopsy? It's hard to get a good sample from bone mets, but worth it if you're able to for your own peace of mind.

Thinking of you and sending hugs.

AC40

Thank you for the response.

We will be visiting the oncologist today and will then proceed with the biopsy. I will share the results as soon as we receive it.

Thanks for your support.

pajim

AC40, I hope the biopsy is successful.  For everyone else who may read this, different scanning modalities show different things.  PET scans show uptake of radioactive sugar; cells which are dividing rapidly.  Normally those are cancer cells but could also be inflammation and things of the like.

Bone scans show areas of the bone which are "not normal".  Could be cancer, could be cancer which is gone, could be some other kind of healed lesion.  If you broke your arm as a kid it would show up as "abnormal" on a bone scan.

MRIs show yet something else.  I don't remember all the details.

You can read more about this at http://www.breastcancer.org/symptoms/testing/types