[Carcinoma of the breast: diagnosis of sub-clinical bone metastases. Predictive value of isotope bone scan (author's transl)].
The possibility of drawing a distinction between two groups with or without bone metastases is of fundamental importance in the determintion of management. With this in mind, isotope bone scan using Tc 99 was performed routinely in 99 cases of locally advanced non-metastatic carcinoma of the breast. Amongst 121 "operable" (T1, T2, T3, N0, N1a) carcinomas, 4 (3%) had a positive scan. Of these 4 cases, 3 showed evidence of bone metastases within one year, in 3 of which the site was not the same as that predicted by the scan. Amongst 53 "inoperable" (T4, N0, N1, T., N2, N3) cases, 5 (10%) had a positive scan and 5 a doubtful scan. Amongst the 5 positive cases, within one year metastases were seen at the predicted site. In agreement with a large number of authors, it would thus appear that routine isotope bone scan has no role to play in the pretherapeutic assessment of so-called "operative" breast carcinomas.