MRI/Bone scans?

Hiya all - just wondering - should everyone get CTs, MRIs amd/or bone scans?? My cancer was Stage 1 (none in sentinel node) but grade 3. Is there anyone else who hasn’t had these tests?

Marina

Hi

Mine was grade 3, stage 2, but I haven’t been offered any scans to check for spread (had an MRI of my boobs, but that was because my cancer was lobular).

There have been various threads about this subject and it seems that practices vary round the country, but it’s quite common NOT to be given scans as a mattar of course.
Dx

It varies around the country, but when I was diagnosed over 5 years ago I was only given a chest x-ray and the usual blood tests. I asked an oncologist relative of mines about scans and he told me they don’t do them as standard because the cancer has to be the size of the nail on your little finger before a scan will detect it. My cancer was an aggressive stage 3 with node involvement and was Her2+.

Hi. I think it depends on the health authority whether you have them or not. In an ideal world every patient would be checked over to check for spread. But-they are costly. I have them, luckily my oncologist believes in the blast 'em/fry 'em or zap 'em as early as possible as he doesn’t like surprises, nor do i!..xx

Thanks for all the replies - just having a paranoid spell where every thing I feel or have felt I worry about!! I seem to be passing through it though!!

I was given a CT because my nodes were affected, the CT showed up a lesion in one of my vertebras and as they couldn’t tell what it was I was then given a bone scan. Onc said she’s still not sure what the lesion is but says an MRI wouldn’t be any more helpful just now and advised against it.

Hope this helps,

Christine xx

Hi Christine, the only thing I would say is that an mri is so clear the radiologists and oncologists can tell straight away if it is lession, tumour or degenerative disease. This may put your mind at redt, it may also change your treatment plan…I had hotspots on my bone scan, had a mri which showed a, thankfully,degenerative disease. They look very different on an mri and the experts who read them can see straight away what it is…I would insist on one, even if its to rule out a tumour…

If no node involvement then it would be extremely unusual to do any further investigations… If tumour is larger than 2cm we would do only a chest xray… If nodes positive at biopsy we would do cxr, abdo CT and bone scan, if multifocal lobular cancer or unable to see a suspicious lump on Mammo and us then occassionally do breast MRI.

Often scans will not be carried out unless at least 4 nodes are positive.

Lulu x

Sadly, I had no node involvement and docs very hopefull. BUT a ct scan prior to my mx showed 2 tumours on my liver…cancer, as you know Lulu, does spread through the blood. You are usually the voice of reason and can always be relied upon to give good, sound advice.but in my case, and others, no node involvement does not rule out spread. Xxxx

Hi horsie

I know that neg nodes does not rule out spread but greatly reduces the chance of spread and nothing is 100% and although cancer cells can travel though the blood this isn’t a common occurrence… Having a scan at the time of a primary tumour with no node involvement is unlikely how anything elsewhere in the body without any evidence of symptoms… Before a cancer cell gets big enough to be seen on CT or bone scan it would need to have been there a long time and in many situations it wouldnt change the treatment plan… There has been lots of research on this and it found that knon about mets before you have symptoms doesn’t tend o chanfe the outcome except that you know about it longer and therefore worry about it longer.

Even if the nhs had the money to give a CT and bone scan to every BC patient after treatment was complete this isn’t what scan are designed for… Imaging is not there merely for reassurance it’s a diagnostic technique used to look for problems.

A scan is also only a snapshot in time like mammos it only shows you what is happening today but not what is happening In a month or a years time and can only pick up cancer from around 3mm in size… As many people ar aware they also show up benign lesions and these have to be investigated too… I know a number of people who were diagnosed with mets based on scans which they later retracted and said were benign changes… Such a worrying time .

Even for people who do have spread the actual timing of scans can be an extremely emotive subject, as often people think or worry that things are worsening when they are not or feel reassured things are improving when indeed it’s the opposite. Waiting for scans and results is an very worrying and traumatic time for most people.

It is a very controversial topic and unfortunately there is never gonna be an answer that is right for everybody.

Lulu xxxxx

Thanks Lulu, your ,as always, very sound explanation. However I beg to differ…I was diagnosed with secondaries to the liver a day or two after my primary diagnosis. This did change my trestment, I had chemo instead of straight onto hormone therapy. Knowing I had liver mets ment I had another ct after cycle 3 to check if I was responding to it, luckily I was. But if we did not know about then it would be left unchecked, growing happily as I would not have been on the correct drugs to focus on my liver mets. Luckily a regular ct scan will show a 4mm or larger tumour and can be treated with the correct drugs/cyberknife/surgery before. I get symptoms and it’s too late. You are very correct in mentioning about the worry, but i’d rather know exactly what I have and be treated accordingly rather than assuming I was clear. I do appreciate that not everyone wants to know everything but I would rather have a treatment plan altered according to my disease. How can an oncologist truthfully tell his/her patients that there is no spread if they havn’t looked? My tumour markers were 24, very low and I had no symptoms…xxx

Horsie I don’t think your reading my posts quite right I didn’t say that your treatment plan would be changed or that mets would ot be picked up just that for the majority of patients mets wouldn be picked up and for the majority if mets were diagnosed the treatment plan wouldn’t be changed… If your mets had been bone mets for exam,e which is the most common site for BC mets then they may have continued with hormone therapy rather than Chemo… Hormones can still have pretty good effects on mets andi have a number of friends with mets on their liver who are on AIs and responding very well without Chemo.

Obviously everybody is very individual and your own team are best placed to know every bodies individual needs.

What I am saying is there is little point scanning 1000 people to find 1 met… I don’t know what the figures are but my latest cancer being 1 in 1000 I know how it feels to be in that minority but I still do not think that everybody should have their interpectoral nodes removed just in case.

Lulu xx

An oncologist can truthfully say from the evidence they have their is No sign of spread… Just in the same way if they do a scan and their is no sign of spread… It doesn’t mean that there may be spread somewhere they haven’t looked… Usual scans as I have said are cxr, abdo CT and bone scan… But some people get spread ovaries, eyes, brain… These are not routinely checked but how can your oncologist error fully say to you it’s only in your liver if he hasbpnt checked every single part of your body… The answer is this is com Kerry unrealistic and they cannot look at everything… They chose to look at the main bits… Bones, lungs and liver as they are the most common site for BC mets.

I am ony saying why they do the things they do not that the should or shouldn’t or that it’s right or wrong… Just that’s the way it is for the majority.

Lxxxx

Sooo agree with you, it would be a waste of resources to scan every inch of your body, what my point is… If a patient presents with a suspicous lession in an area known for mets of that particular cancer, then the onc should investigate further. As treatment plan MAY change. I won’t be responding any more. Tara folks.xxx

Wading in here.

I was diagnosed with bone mets at same time as primary in July 07. Only scan I had then was a bone one a couple of weeks later. I had an u/s at initial diagnosis, one half way through chemo and one after chemo prior to surgery. After surgery when I had a mx and full anc (12/22 nodes plus extra still affected even after chemo) I had another bone scan - still no CT or MRI. I have had bone scans done at least once a year since then, depending on whether I have any extra aches. The bone scan I had in Dec '10 showed some spread in spine and as I was having aches and pains below my ribs, they did an u/s on abdomen, later they did a CT and then MRI but this is the only time I have had these other 2 scans. The CT and MRI just confirmed the size and location of the bone spread which was then zapped with a one-off rads dose. Am having a mx on my ‘good’ side in a couple of weeks or so to try and balance me up - it’s at my request but no reconstruction. Not expecting any more scans for that op.

Liz