[Lani]

In the best of all possible worlds, a bone marrow or bone biopsy might be standard of care to determine if what is lighting up on the bone scan (which could be tumor, microfractures or infection) is indeed tumor and whether it is or isn't her2+. Not all her2+ tumors metastasize as her2+, although the vast majority do.

I would be nice if you had a clinical trial in your neck of the woods in which they were trying to biopsy these lesions. You did not say where they were--some areas of bone are weightbearing so if a larger biopsy of bone were performed you might have to be on crutches afterwards (Never for a bone marrow test).

I have no knowledge of it being state of the art here EXCEPT at every conference I go to they say that clinicians should try to biopsy every metastasis to determine its ER,PR and her2 status and be sure it hasn't changed. Don't know if that changes government pollcies and how much leeway your treating doctors might have

Sorry to ramble--am not sure I have contributed much helpful but you can quote me as one who attends the AACR, ASCO and San Antonio meetings yearsly as well as ASCO breast and AACR breast when they occur as having heard the underlined voiced emphatically at every meeting.