Bone Scan

Cancer_Journey

I am 39 and was diagnosed with breast cancer in my left breast just before Christmas. I have the BRCA1 gene, so I am high risk. Things are moving along very quickly. I thought I was in the clear after seeing my surgeon, Dr. JC Gauthier, yesterday and getting a date for mastectomy of Feb. 9th. Today the hospital called me to set up a bone scan. My surgeon said nothing about this yesterday so I'm quite rattled by it. Is it standard procedure to have a bone scan before surgery or does it mean they've found something?

ChiSandy

What kind of bone scan? A bone density scan is usually done in postmenopausal patients with hormone+ cancers, with adjuvant aromatase inhibitor therapy planned, as a baseline to determine bone strength before treatment; scans are repeated after treatment starts, to see (in non-osteopenia women) whether the AIs have weakened the bones sufficiently to require adding bone-strengthening drugs, or in osteopenic or osteoporotic women after a few months on bone-strengthening drugs to assess how well the drugs are working. A nuclear bone scan (with a radioactive isotope injection) is sometimes done to check for metastasis (which would alter treatment) or to see if bone pain is caused instead by injury, inflammation or osteoporosis instead of by metastasis. A few years back when I had hipbone pain and an avulsion fracture of the iliac crest w/o having fallen or hit something, but was too young for osteoporosis, a nuclear bone scan was done to rule out bone cancer--it showed inflammation from a bone harvest that had been performed at that site 8 yrs earlier to repair a tibial plateau fracture.

Kicks

A Bone Scan is quite common to be done to look for mets (to be on the safe side) - even when not expected - before the TX plan is finalized. It involves injesting and or injection of nuclear 'stuff' that will cause it to 'light up' on mets. It is more commonly used with some types of BC than other types and for different Stages or Grades. Does not automatically mean "We think there's mets" - but to be on the safe side. It is also not unusual to have full body CT/MRI with contrast or PET Scan before TX for the Drs (Surgeon/Chemo Dr/Rads Dr) to have a more complete idea of what is needed in the TX plan.

A Bone Density Test (DEXA) is a 'test' not a Scan'. They are very different and used for different reasons. A DEXA is used to check the density of bone dealing with potential Osteopenia and Osteoporosis. It simply involves x-rays and is not associated with a BC DX. There is no nuclear 'stuff' - just X-rays of the hip area to check how dense the bone is. I've been getting them for MANY years (long before IBC) because of a huge family HX of osteoporosis. They are commonly done for post menopausal women and ones on estrogen blockers (ER+ BC).

Sounds like they are just being thorough. If you are concerned - call your Dr(s) and ask for an explaination that only your Dr(s) can give you personally knowing all the mammos/US and biopsies reports. No one here can tell you why the decision was made - we can only give our personal TX plans which is absolutely not the same for each of us.

What did the rest of your team, your Chemo Dr (Medical Oncologist) and Rads Dr (Radiologist gical Oncologist) tell you of your total TX plan?

LisaAlissa

Hi Cancer_Journey!

At this point, everything that you don't expect is alarming...but this could be nothing. Really nothing. For example, for a facility/office that IDs patient's by patient number, a clerk who was to set up a bone scan with a patient could have been given the wrong number...or typed the wrong number. Who knows? But there's no reason to either guess or wonder.

Tomorrow call your surgeon's office and ask to speak to his nurse. Tell them "I got a call to schedule a bone scan, but I wasn't expecting that. Did Dr. Gauthier order that?" If they say no, is there some other doc you're seeing? Make a similar call to them.

If they say "yes," ask what it's for and what is involved in the scan. Once you get an answer, if it's consistent with your expectations, go ahead and get the scan. If you need to have another appointment before agreeing, ask for one!

HTH,

LisaAlissa

BTW, if the answer was "yes," don't forget to get a copy of the order for the scan (and make sure your insurance doesn't require pre-authorization) as well as the scan results, when available.

eta: parenthetical in the last sentence.