Bone Scan Results-Metastatic Disease vs Periostal Reaction

DivineMrsM

Last week I had a CT and a Bone scan. Everything was stable except for some uptake on my left femr (thigh). Report says:

New foci of increased uptake of left femur may represent metastatic disease versus periostal reaction. Recommend radiographic correlation.

So, my onc had me get an xray which she said was inconclusive. Here is what it said:

IMPRESSION:
Smooth periosteal thickening in the proximal lateral femoral cortex without a defined sclerotic lesion that. This probably represents periosteum reaction but nonetheless a follow-up examination is advised. .

FINDINGS:

Ossification is seen along the greater trochanter. And piece of pathic changes also seen at this level. Along the lateral femoral cortex there is a thicken region of periosteum that has smooth margination along the proximal 1/3 of the femur. This may reflect periosteal reaction. No defined sclerotic mass is present. Metastatic lesion in the cortex is not entirely excluded and as such, follow-up is recommended.

The onc says since this is inconclusive, we will just follow up in three months.

The bone scan report says this could be "periostal reaction" vs metastatic disease. My physical activity increased this summer when I began walking daily and also going to the pool often. I have lost almost ten pounds in the process. I wonder if that has anything to do with this.

The scans show I have arthritis in feet, shoulders and spine. I have been stable on arimidex for almost six years.

I am not sure what to think. Has anyone else had this type finding on a bone scan? Should I request a biopsy at next onc appointment? Not sure how concerned I should be.

AmyQ

Devine,

I don't have an answer for you, only wishing you the best. I hope you can find an answer.

Amy

DivineMrsM

As the forum was experiencing technical difficulties this morning, I am posting to bump this thread to see if anyone has advice to offer. Thanks.

Kandy

Good morning Mrs Divine, I know that we all get very concerned as soon as they say anything on a report that suggests there might be something going on. But by what they dictate, I really wouldn't be very concerned at this point. Any time the radiologist can not be 100% sure,they would want a follow up, just to make sure nothing is there. On both reports, neither could identify a lesion, which is good. Now, lesions must be a certain size in order to be seen on imaging, thus the reason they want a follow done. But really, the reports do not indicate that they are very concerned. As far as your activity increasing having something to do with it, I really don't think so. And as far as you questioning a biopsy to be done at this point, definitely not. There isn't even a lesion identified. I would follow up just like they recommend. When you get that report, then it will be clearer if anything else needs to be done. Wishing you the best. Enjoy the moment and always praying for everyone

DivineMrsM

Kandy, you are really super! I am so thankful to have your input on this and your comments are thorough and very calming. It is so nice to be able to get feedback from you with your tech background. I greatly appreciate your response. . I guess I wondered if the onc was making light of things, it is just how my mind works!

Zillsnot4me

My latest scans didn't say exactly that. But there was uptake. I was concerned like you. It was explained to me the spots weren't new, weren't big enough to biopsy and I feel good. No new ongoing pain or unexplained weight loss.

I personally don't want a biopsy anytime soon, am happy to stay on my current treatment as it seems to mostly agree with me. Now if I could get more active and lose 10 lbs. Wahoo! You are my hero.

It's hard with all that mumbo jumbo and of course they need to be cautious. Just remember the oncologist knows us whereas to the radiologist we are a set of pictures.

DivineMrsM

Zills, thanks for sharing your insight. Interesting observation about the onc who knows us vs radiologist to whom we are a set of pictures! I do not have any pain in that area, so hearing your comments and Kandy's, I am okay with how the onc handled this,

I am glad to have lost weght, tho I will say I am often hungry! Also, my body is sore from walking because of arthritic feet and sore joints from taking Arimidex. On the other hand, it feels good that my clothes fit me better. I guess its all about trade offs! Prior to my walking routine, I really felt and looked bloated, so I needed to shed some pounds.