Significance of Sclerotic Mets?

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MaineRottweilers
MaineRottweilers Member Posts: 156
edited May 2016 in Stage IV/Metastatic Breast Cancer ONLY

I tried searching the bone mets thread but it was too difficult to wade through and get meaningful information. I am hoping that someone can give me a little primer on bone mets.

I am HER2+++ and PR+ (50%) and currently have only skeletal mets. I have been on weekly Taxol with Herceptin/Perjeta q3w and monthly Zometa.

I had a CT yesterday and picked up preliminary results which indicate localized sclerotic changes involving T10, T11, T12, L2, L3, L4 & L5 as well as right ilium and right femoral head. Previously (Dec 5), 10mm and 12mm sclerotic lesions were seen at T10 & T11 only. This report only gives a measurement for L4 (14mm) but not for any of the other lesions it just says "smaller" it also concludes with. "other vertebral bodies also have tiny sclerotic metastases" but doesn't indicate which others, they may be.

I know I will get a final and conclusive report as well as an explanation from my MO at my appt on Thursday but I was just hoping to determine the significance of these remarks so I can go in prepared and armed with questions. Does sclerotic indicate healing?

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  • Kandy
    Kandy Member Posts: 1,461
    edited March 2016

    There are 2 types of lesions. Sclerotic and Lytic. Sclerotic is more dense and Lytic has like holes in it. Less dense. On scans there is a distinct difference between the 2. They can also tell rather they are healing and if they are they state that. Wishing you nothing but the best.

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  • Xavo
    Xavo Member Posts: 364
    edited March 2016

    screlotic lesions can be both osteoblastic lesions and healing bone lesions. As osteoblastic lesions (bumpy bone surface caused by the bone making more of itself under the cancer attacks), in comparison with its opposite, osteolytic lesions (holes in the bones caused by the bone retreating from the cancer's attacks, osteoblastic lesions suggest slower growth of the cancer. That is, when the bones have the time to resist against the cancer's attacks, it produce more of themselves. When the cancer's attacks are more speedy, the bones will have to retreat by removing themselves from the cancer. So, in either case, screlotic lesions are more favorable. In your case, if your scan reading used the term "screlotic changes", it is more likely a suggestion of healing. Hope it helps.

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  • MaineRottweilers
    MaineRottweilers Member Posts: 156
    edited March 2016

    It does help! Thank you for the info.

    The news is kind of mixed but overall quite good. Good news is that there is still no visceral involvement, very good news indeed! The so-so news is that CT keeps picking up new skeletal lesions but they are not confirmed as active, i.e. they don't pick up dye on the bone scan and last time didn't show activity on PET. The beast is slumbering but is not dead nor gone. It's the best I can hope for and really is good news too but troublesome for me to wrap my brain around that change is still occurring but not confirmed as actual progression. I really want to hear NED, no evidence of disease or even remission or stability but those are not words uttered or written, yet.

    That said, I am going off chemo for a while. It's not doing anything miraculous and it's making me feel really sick so why take it? By going off it, we can evaluate if it is having any impact on slowing down progression. I'm going to continue to get targeted therapies, via infusion, every three weeks, Herceptin & Perjeta. I am also going to start taking daily Arimidex, we don't know that it will be useful given my weird, ER negative, PR+ (50%) pathology but it's worth trying. If I don't like the side effects, I will discontinue it but I will give it at least 12 weeks to see if it is beneficial.

    So continues life of a stage IV patient, metster, lifer, whatever you want to call it. Taking life in 12 week increments and re-evaluating. I hope I have lots of time to get used to it.

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  • dixiebell
    dixiebell Member Posts: 280
    edited May 2016

    Does anyone know the best biophosphate for sclerotic bone mets.

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