Confusing bone scan results letter.

Hi all. I’m most probably just over thinking it but I’m confused and a tad upset with my BC nurse over bone scan results.

I had the scan 2 weeks before Christmas due to low lumber pain that was extremely painful at times, ok other times and even odd days pain free.  BC nurse rang me just before Christmas to say everything was fine but it showed some degeneration in the lumber region which was age related. Obviously a very happy bunny and joked about getting old ain’t no fun! I am 68

Just seen the letter to GP today and got a tad upset and confused. BC nurse had said and I quote…

This has shown no convincing evidence of bone metastasis however there is degenerative pattern of tracer uptake in the vertebral column in the lower lumbar spine, specifically L5-S1 level. This has been evident on previous scans and felt to be benign in nature. End quote.

This is the first I had heard of any degeneration. I had a bone scan a year ago due to back and shoulder pain. All the letter said last time was “_no evidence of any bone metastasis”. _Not One word about degeneration! 

The other bit that has slightly concerned me is her saying “no convincing evidence” this time   rather than “no evidence” like before and also saying “felt to be benign” when talking of the previous scan and degeneration. It’s the word ‘felt’ thats niggling me and would have felt better if she said ‘is benign’
I have emailed my BC nurse and asked why I wasn’t told about the degeneration when letter indicates I have and previous letter proves that I wasn’t told. Also asked what she meant by convincing this time.

I know I may well be over thinking but it’s hard not to when you find things out and should have been told before. 

I just wanted to ask here if this or something similar has happened to anyone else.

Thank you for reading.


Frances xxx

Hello Frances

I’m just acknowledging your post. I’m afraid I’m in no position to interpret oncologists’ letters. Two years on, mine still say my bone scan is awaited - I had it in January 2019!! I only skim the letter but I always check if this bit’s changed.

There is a big difference between the spoken and written language in cancerworld. The letter is aimed at another medical practitioner and therefore is medical-speak which you are in no position to dissect. It may be a simple matter of different oncologists dictating in different ways. I would say you need a further conversation with your breast care nurse who can explain better. Tbh, if there was any question of metastasis, they’d have had you in like a shot. 

As regards the ‘age-related’ issue, I’m finding I’m getting it more frequently than I’d like (I’m 69), most recently a rheumatologist identifying all number of lumps and bumps as osteoarthritis “expected at your age”. It really pisses me off lol.

Hope the b-c nurse reassures you xx

Hi Frances,

I can understand how you feel at seeing the letter. Besides Jaybro’s comments about medical speak in letters, oncologists and radiologists are always careful in their phrasing. As I’m sure you are aware in any of us who have had bc, for understandable reasons no oncologist can ever say absolutely that there isn’t a lone bc cell hiding out dormant in the bone. They will have reviewed your nuclear bone scan at a very high level of magnification. Nuclear bone scans just show uptake where there is ageing or other damage to the bone, so if they were unsure, I’m sure they would have recommended a follow up scan of another type. However I agree that a follow up conversation would be worthwhile to help clarify matters and put your mind at rest. 

My nuclear bone scan due to rib pain came back as “highly suspicious of bone mets” showing 2 very large areas and a third smaller area. I asked to see the scan when I saw my oncologist - she touched my hand and said she hated giving bad news and told me I should prepare myself. Had a rather agonising wait (while trying be be positive) for another type of scan and results. It turned out to be rib fractures (hurrah!) from years back, which I never knew I had, and a patch of ageing. They refer to this as a false positive…apparently it’s quite common and causes so much stress in the process.

They also said my patch of ageing degeneration was quite normal…in my 40’s!  So ditto your/Jaybro’s feelings re ageing (plus some re my lower age!) - degeneration is such an unpleasant word/term!

I suspect they must see patches of ageing in most of the bone scans they do on anyone over 40? mid 40’s? 50? which is probably why they didn’t mention it when you previously had scans? Like you I’d always rather hear what they’ve seen even if its ageing changes to bone, however I guess a lot of people prefer not to know details re such natural changes, particularly when going through bc and associated follow ups. 

Sending you a big virtual hug - it’s never good to feel unnerved by wording in a letter, so a follow up conversation is definitely worthwhile and I hope it sets your mind at rest.

XXX Seabreeze