Need help! Kind of in a panic about bone scan results
 

I recently had my onc order a abdominal CT and a bone scan due to my lingering worries about mets. As you can see from my signature, I am not statistically at great risk for them, but I had not felt well for about 6 months prior to my diagnosis, so my onc generously ordered both to put my mind at ease.

Well, the CT came back all clear (yay!), but the bone scan came back...."abnormal radiotracer uptake at the L4 pedicle which may represent metastatic disease". The radiologist recommended an MRI for further assessment.

Can you help me with what this might mean? I KNOW it might mean mets, but how often do women get this kind of result then on further testing it turns out to be nothing....Often? Sometimes? Never? I know none of us are Docs, and I have no choice but to wait for other tests for the real story on this, but any info you can give me would be appreciated.

Thanks so much!

Erin...Take a big deep breath!!! This doen't necessarily mean mets...it could be anything...BUT...if it is mets..there is only one spot which can easily be zapped with radiation...or go away on its own with the use of hormonals...IT IS ONLY ONE SPOT!!! I know this may not help your panic and I wish I could hug you...I know that ugly fear...it could be a touch of arthritis !!!
Waiting really does stink...
Tammy

Tammy,

Thanks for your reply :-) I know I am so lucky compared to so many others on this board who have much bigger problems than I do. Do other kinds of things show up on bone scans? You mentioned arthritis....I have had a "bad back" for years due to an injury in my 30s....about in the same area. Could the old injury, or arthritis light up on a bone scan?

Thanks

Erin, I had a CT/PET scan when my tumor markers were elevated. It came back showing uptake on my left flank. Luckily, I knew immediately it was a cyst and benign. I was the one who actually idenitified it as a benign condition and then had them confirm it by measuring the spot they found with uptake against the location of my cyst (more than twenty-five years in one place, so if it's cancer it's holding steady). The scan also revealed lung nodules, which were originally identified in a lung scan in 2001, and which are also benign. The radiologist is looking at uptake and many, many benign conditions have uptake. Radiologists must also protect themselves by mentioning everything they see. It's wise to wait for the MRI. That your CT was clean and the bone scan found only one spot is good news and it probably is something benign. Good luck.

Dear Erin,

No matter what stage it is the same bond we share....
Of course you are concerned...but I am sure it will
turn out to be just fine. You are currently on a great
treatment and are doing everything possible. Please
keep us posted! In the meantime - and I know how
diffiuclt it is but... do keep a positive attitude - remember you are
currently on TCH...and you need your good energy to work for you
so take a deep breath....all will be fine!

Will continue to keep you in my prayers.
Jean

Dear Erin


Although your doctor wants to rule out a met, you have already indicated that you know you have an old injury there and arthiritis does light up an old injury like a Christmas tree. This same thing happened to me with my ankles (from high impact aerobics when they first "came out" on the market) and nobody knew the damage they could cause. My doc said the same to me - your ankles are all lit up and we have to rule out everything - I really wasn't too concerned because I'd had trouble with the right one (even though the scan showed my left was worse).

My mom (who also had bc) lit up her hip and it was from an old injury sustained in a car accident.

Yes - it could be something but I highly doubt it given your stage, tumor size etc. Unfortunately, you have another "wait and see" situation on your hands that I wish you didn't have.

Think "old back injury" and just have a nice weekend.

Big hug to you

I got alot of bloody noses while I was on Herceptin and my bone scan lit up my nasal area like Rudolph. Also my big toe...I had bunion surgery in 1996. Hope your results turn out to be something simple!

L4 is one of the disks in the very lower back. Would be an ideal candidate to have some arthritis to show up. I actually had to have disks trimmed at L4/L5 and L5/S1 a couple of years ago.

Good luck to you!

Kathy

Erin,

I had a bone scan about 5 years ago because my hips were bothering me - my scan lit up like a XMAS tree - diagnosis was bursitis in the hips.
My onc. ordered a bone scan for me in November 2006 after the initial diagnosis, and this one was clear.
I am hoping for the best for you.
Keep us posted.
Caya

Don't get me started about this: I had two chest CT's where the radiologists (who didn't know me at all) literally wrote "metastatic disease" on my report. As it turned out (2 pet scans, more Ct's and bone scans, etc later) I had minor radiation damage on my lung. I did not have mets. As the other women have said, it's some radiologist on call, reading your scan and covering all bases -- and with a bc history, they are looking for mets.
Take a deep breath and wait for back-up scans to get more info. It's very common at our age to have minor asymptomatic arthritus in your spine. Very common.
Hang in there. Try not to go there until you really know what' s going on.
Take care
Linda

Last summer I started having pain in left hip. Onc sent me that day for x-ray and bone scan. I was able to watch the entire bone scan (I did this also with initial base line bone scan after dx, so I did have a frame of reference).. Left lower leg lit up (broken leg 10 years ago), right elbow lit up (surgery one year previous), and left hip ended up showing arthritis! X-ray also showed bone spur inside hip socket. So I obviously have had and do have problems---just not mets!

Try not to worry, lots of things show up that are not cancer related.
________
Whip vaporizer

thoughts
 

The pedicle is the part of the vertebrae that metastases usually like to set up housekeeping in rather than the vertebral body, transverse process, spinal process or lamina. There are two pedicles to each vertebra and they sit between the back of the vertebral body (the marshmellow shaped main part of the bone) and the two transverse processes. They are distinct from the facet joints(also two per vertebral level), which are the only true joints in the back, the ones which can get arthritic.

Bone scans pick up processes which tend to affect the cortical (hard outer) rather than processes which tend to affect the spongy (more porous inner) bone--metastases are usually thought be affect the inner part of the bone first and primarily. MRIs tend to show up processes affecting the inner part of the bone better than the hard outer shell.

That is why I think the radiologist suggested going to an MRI rather than a CT
(but of course I could definitely be wrong)

My 86 year old father just had an abdominal MRI which showed something affecting two transverse processes in his lumbar spine. A bone scan lit up in the area as well as in his sternum (Breast bone), right costcochondral junction(junction of rib and cartilage) around rib 5 and also in the mid rib 6 area--just along the course a seatbelt would injure one in a collision. And, yes, my dad was involved in an auto
accident this past fall. In fact, an area of his pelvis injured 15 months ago when the dog pulled too hard also lit up on the bone scan.

Not to bore you, just to point out that many things can light up and even more than one year after the occurrence.

Hope some of this helped.

You guys are wonderful!!! :-)
 

Thanks for all the info! It is impossible to not worry some, but knowing the plethora of thing this could be, besides mets, makes me feel sooooooo much better! As always, your personal experiences are so much more informative and meaningful than all the research...

I'll post when I know more, but you your kind words, encouragement and positive stories haver really eased my mind!

Thanks!

Never posted before. Hope I'm doing this correctly! Im not familiar with this Web site but so glad I found it, and particularly this message. We're in the same place re bone scan results! I've been having left rib pain for two weeks (in the area of my lumpectomy and SNB from last June), so onc scheduled a bone scan this past Wed. Different than my clear scan at dx last June, this one lit up at the fifth vertebral body--interestingly, nowhere near the area of my rib pain, which did not light up at all! I had a followup MRI yesterday and, of course, I have to wait until Monay for the results. I had myself dxd with mets for sure until I started reading all the messages regarding the current post and the long list of potential other causes for the hot area. I think I can breathe again! So glad I found this site and this particular message! Here's hoping that we both get good results from our MRIs. It's just so terribly difficult to stay calm. I truly don't like feeling I'm just one test away from potential disaster. I'm hoping that with more time beyond the dx and when my trmt is complete, I won't feel quite so vulnerable....

Marie
DX 6/12/06
IDC, 1 cm, Stage 1, Grade 2, ER-/PR-, HER+
Lumpectomy, DD AC, DD T, 33 Rads
Herceptin weekly for 52 weeks (until 9/07)

Marie,
I have my fingers crossed for both of us ;-)
What secondary testing did your onc order? MRI? CT? SPECT?

Erin,

My onc ordered an MRI. I had it done Friday evening and received the results this afternoon. No mets!! It's just arthritis. Never thought I'd be so happy to have arthritis!! I couldn't wait to get home to my computer so I could post to let you know the results. When I read your post the other day, I could tell your mind was going exactly where mine was. It's so hard not to do that! But I wanted to reassure you that it definitely can be something noncancerous. I'm hoping it will help put your mind at ease while you wait for your next step.

The way my onc explained it, the bone scan can only tell an area of heightened activity but cannot define that activity, which can be soooo many different things. The MRI is a much closer look at the area, including tissue, organs, vessels, etc., and can identify the nature of the process/activity. I asked why they don't just do the MRI from the get-go but apparently the MRI can only look at one specific area of the body at a time and not the entire body. So they do the scan first to see if there is a problem and then follow up with the more localized definitive test.

Hope this helps. Please post back so I know how you're doing. I'll be thinking about you.

Marie