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Topic: Bone Scan for Breast Cancer Patients

Forum: Just Diagnosed — Discuss next steps, options, and resources.

Posted on: Sep 13, 2009 05:48AM

angelcakes wrote:

When you were first diagnosed with breast cancer, did your doctors recommend for you to have a bone scan as well to make sure that the cancer did not spread to your bones?  I just wanted to know does doctors make all people who have been newly diagnosed with breast cancer to have a bone scan as well just to be on the safe side to make sure that the cancer did not spread to the bones?

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Sep 13, 2009 05:49AM Morgan513 wrote:

I had a bone scan along with cat scan, x-ray, mri.  I'm not sure if everyone has this though.

Lorrie

Dx 4/9/2008, 2cm, Stage IIa, Grade 3, 0/3 nodes, ER-/PR-, HER2-
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Sep 13, 2009 06:04AM crazy4carrots wrote:

Hi Angelcakes:

If your pathology indicates no lymphatic or vascular involvement, I can't see why a bone scan would be necessary.  However, most oncs (I think) would recommend a baseline bone density scan, especially if you are post-menopausal and about to go on one of the aromatase inhibitors(which can deplete the calcium in your bones and cause osteoporosis).  But of course it's up to your oncologist.

Prior to starting chemo, I had an X-ray, Muga scan and bone density scan.  My bs and onc did not think it necessary to have any further expensive scans.  I did consider an MRI, and it would have been ordered, but together we decided it was not necessary at that time.

To follow by faith alone is to follow blindly -- Benjamin Franklin

Dx 1/10/2008, ILC, 1cm, Stage I, Grade 3, 0/4 nodes, ER+/PR-, HER2-
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Sep 13, 2009 06:05AM SoCalLisa wrote:

Hi there Angel

Ordering a bone scan for newly  diagnosed BC patients is pretty standard..

Just wanted to hold your hand and give you a hug

I will be a nine year survivor in a few weeks...

DX 2000-IDC-DCIS-LCIS- 2B..POS NODE--ER+. PR+, HER2 NEG

Dx 11/24/2000, IDC, 2cm, Stage IIb, Grade 1, 1/8 nodes, ER+/PR+, HER2-
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Sep 13, 2009 06:08AM, edited Sep 13, 2009 06:11AM by swimangel72

My breast surgeon had me get a bone scan (because I complained about on-going hip pain) and he also ordered an MRI of both breasts prior to my mx. At that time, my ENT had also ordered a brain MRI because for the past 3  years I was experiencing vertigo - and he wanted to be certain that it was only Benign Paroxysmal Positional Vertigo (treatable with an Epley Maneuver). I also had a bone density test done - my breast surgeon wanted to get a reading for osteoporosis prior to all my treatments. I was so happy when all these tests came back B9..........the peace-of-mind moving forward with treatment was enormous! Oh - and one more thing - before he would even schedule me for surgery, my breast surgeon  also ordered the genetic test for BRCA1 & 2 (thankfully negative for both those genes.) He was extremely thorough - he even sent out my tumor tissue sample to a separate independent pathology lab to be absolutely certain that it was indeed IDC.......which it was. I'm so very grateful to my breast surgeon for his thoroughness (even though his office-staff was disorganized and lost my FISH report which proved I was Her2+++..........fortunately  my oncologist picked up the slack and had that report faxed to him - he was so thorough himself, he sent it out for a second FISH report, which agreed with the first. My oncologist also ordered the Oncotype DX which unfortunately was an "iffy" 22.........I ended up with chemo and Herceptin solely because of my Her2+ status.) My oncologist also had me get a MUGA scan before starting on Herceptin - and another one half-way through - and a last Muga scan when I finished Herceptin after a year.

Sorry to go on and on - I just feel so lucky that I live near a major metropolitan area (NYC) and had the opportunity to use such wonderful doctors (not including my original PS in this assessment........he was NOT the best, unfortunately - but my new PS on Long Island is wonderful! 

Good luck with all your tests and treatments - may God's angels watch over you!

3/3/08 Right-side mastectomy with immediate muscle-sparing free tram; 3/9/08 Developed abdominal MRSA staph infection and hernia;Completed 4 months Navelbine and 1 year Herceptin; Arimidex - 3 more years! Diagnosed at age 53

Dx 2/5/2008, IDC, <1cm, Stage Ib, Grade 1, 0/7 nodes, ER+/PR+, HER2+
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Sep 13, 2009 06:17AM dlb823 wrote:

angelcakes ~  I think it's a judgement call.  I had one prior to chemo, but I also had 1 positive node and kind of a long, dragged out wait between my initial lumpectomy and when I finally started chemo 10 weeks after a mast.  So I figured that delay of 6 mos. between my original dx. and starting chemo was the reason my local onc wanted to be sure we were still okay with the rx'd chemo plan.  But when I happened to also meet with my other onc (at a major university hospital), she seemed surprised my local onc had even ordered a scan, although she said it was probably a good idea. 

If you want one, by all means ask your onc for one.  Your peace of mind is as important as any tx.   Deanna

"The soul would have no rainbow if the eyes had no tears" Native American proverb

Dx 2/1/2008, 1cm, Stage IIa, Grade 3, 1/16 nodes, ER+/PR+, HER2-Dx 1/3/2014, Stage IV
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Sep 13, 2009 08:11AM angelcakes wrote:

SoCalLisa that is really great that you are going to be a nine year survivor in a few weeks.  I am truly happy for you.  I read nothing but negative info online about triple negative breast cancer and it makes me very happy to know that there are people out there who have beaten this awful disease.  I have been in remission for 20 months now and i pray that i never have to face this disease again.

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Sep 13, 2009 08:16AM chelev wrote:

angelcakes  - hello, and unfortunately, welcome to the club.  I had a bone scan, PET / CT scan and MRI once my biopsy came back with IDC.  They are all important tests that help the doctors determine if your cancer has spread.  I think it is up to the surgeon or oncologist - my surgeon likes to do everything on the "let's be safe" scale.  I did not get a bone density test this year, as I had gotten one last year with my mammogram (which showed NOTHING on it - but I had a 3 cm tumor removed this February) and my insurance will not cover another one this year - it has to be every other year.  I will not get another MRI or anything unless they suspect anything is going on, but I will get a mammogram and ultrasound in December to follow up after the lumpectomy, chemo and radiation I had this year.

chelev - TC - 2 rounds (allergic!), Rads - 33 rounds. Oncotype score - 27. Tamoxifen, Jan 2010-April 2013 - too many side effects! BRCA Negative. "If we couldn't laugh, we would all go insane" - Jimmy Buffet

Dx 2/14/2009, IDC, 3cm, Stage II, Grade 2, 0/4 nodes, ER+/PR+, HER2-Surgery 02/27/2009 Lumpectomy (Right); Lymph Node Removal: Sentinel Lymph Node Dissection (Right)Chemotherapy 03/12/2009 Cytoxan, TaxotereRadiation Therapy 05/29/2009 ExternalHormonal Therapy 01/01/2010 Tamoxifen
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Sep 13, 2009 08:21AM angelcakes wrote:

My oncologist had given me a bone scan about 2 weeks after my lumpectomy.  I never asked them what the bone scan was for because i figured that it was something they probably give to all people who have been diagnosed with breast cancer.  I am assuming now that i was given the bone scan because my radiation oncologist had informed me that the breast cancer tumor was very close to my bone.  I am guessing that is why the bone scan was given to me, although my radiation or chemo oncologist didn't mention it to me. Fortunately the bone scan came back not showing anything wrong. I only pray that i continue to stay in remission.  Thank you wonderful ladies for taking the time to answer my question and i wish nothing but the best for everyone here.

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Sep 13, 2009 08:39AM hrf wrote:

I have had 2 separate dx of bc. The first was found on mammogram so had u/s and biopsy to get dx of IDC. Before surgery had breast mri and chest x-ray......then had lumpectomy, chemo, rads, pbso. They did not do a bone scan because there was no evidence of lymph involvement at that time.  However, about 18 months ago, I had some bone pain in the rib area and x-ray showed concern so I had a bone scan which said nothing there.

Second dx in January 2009 - doc felt a lump under my arm....had mammogram, u/s, and mri and biopsy on lump under arm (lymph node) .. came back ILC so had chest x-ray and bone scan as part of the staging -- everything done before surgery.

Bone scan is to determine if mets in bones and done before surgery if there is evidence of lymph node involvement. A bone mineral density is a different test that measures strength of bones. I have had a few of these over the years and had one again recently to get new baseline before starting Arimidex.

BRCA2+ first dx in Oct. 2004 2nd dx Feb. 2009 a new primary

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Sep 13, 2009 08:58AM CapeBretongirl wrote:

Hi Angelcakes;  My Onc. told me that in Ont. Canada, it is now standard procedure to do a bone scan on the newly diagnosed.  My Onc. is sitting here with me right now.  Take Care
Dx 5/2008, 6cm+, Stage IV, Grade 3, 1/8 nodes, ER+/PR+, HER2-
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Sep 14, 2009 04:17AM Leah_S wrote:

I had a bone scan, CT scan, and mri before single mast surgery. From what the surgeon said, he did it because I chose mast not lumpectomy and he didn't want to do that if there was mets.

Thank G-d, no mets.

Leah

Dx 11/3/2008, IDC, 1cm, Stage IV, Grade 3, 6/17 nodes, ER+/PR+, HER2-
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Sep 14, 2009 07:36AM newday1976 wrote:

Ymb, are you related to your oncologist? I find it pretty odd they would sit there are you typed idly on a message board! Mine had time to talk about cancer only.

I went to one of the top medical oncologists in Ontario. Stage one (early stage, no nodes) certainly are not required to have any of these invasive tests.Now I don't have my oncologist with me (its the weekend he is likely at the cottage) however, he told me that due to the fact that it is A) unlikely to spread and B) Causes more problems with false positives.

Please do not tell people this is gospel truth, it may be a suggestion.Cancer care ontario sets the guidelines as below.

Recommendations: The following recommendations apply to women with newly

diagnosed breast cancer who have undergone surgical resection and who have

no symptoms, physical signs or biochemical evidence of metastases.

  • Routine bone scanning, liver ultrasonography and chest radiography are not

indicated before surgery.

  • In women with intraductal and pathological stage I tumours, routine bone

scanning, liver ultrasonography and chest radiography are not indicated as

part of baseline staging.

  • In women who have pathological stage II tumours, a postoperative bone scan

is recommended as part of baseline staging. Routine liver ultrasonography

and chest radiography are not indicated in this group but could be considered

for patients with 4 or more positive lymph nodes.

  • In women with pathological stage III tumours, bone scanning, liver ultrasonography

and chest radiography are recommended postoperatively as part

of baseline staging.

  • In women for whom treatment options are restricted to tamoxifen or hormone

therapy, or for whom no further treatment is indicated because of age

or other factors, routine bone scanning, liver ultrasonography and chest radiography

are not indicated as part of baseline staging.

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Sep 16, 2009 05:00AM LRM216 wrote:

Yes, any good doctor will order those tests.  Mine suspected nothing at the time, but had to do them all nonetheless, as they are standard of care by many.  They also use them as baselines. 

Life isn't about waiting for the storm to end, it's about learning to dance in the rain ... Age 62 at diagnose

Dx 2/23/2009, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER-/PR-, HER2-Surgery 03/07/2009 Lumpectomy (Right)Chemotherapy 04/25/2009 Adriamycin, Cytoxan, Taxol, TaxotereRadiation Therapy 10/21/2009 External
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Sep 16, 2009 05:16AM sheila888 wrote:

newday.....When we live in different part of the world recommendations are also different.

I am from NY and yes I did have a bone scan after my lumpectomy.

Because its different in Canada doesn't make it wrong in United States.

Best wishes in your recovery.

Smile Sheila

Sheila♥

Dx 4/8/2005, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2+
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Sep 16, 2009 06:32AM crazy4carrots wrote:

I've just been re-reading the posts on this thread.  One in particular stood out -- Chelev had a bone scan, a PET scan and an MRI following a biopsy which indicated IDC.  To me, that sounds like excessive testing (Chelev, this is NOT a criticism of you, sweetie!).  What would be the point of doing all of that before determining if there was any lymph or vascular involvement, or if there were any other symptoms?

I watched an interview on CNN some weeks ago with Deepak Chopra, who stated that it is estimated that $700 billion is spent each year in the U.S. on unnecessary medical tests.  Of course, there is a fine line between necessary and unnecessary, but how many docs prescribe these tests because they know the patient's insurance will pay for it? (or because they are doing everything to avoid any possible future lawsuit......)

Just wondering.....

To follow by faith alone is to follow blindly -- Benjamin Franklin

Dx 1/10/2008, ILC, 1cm, Stage I, Grade 3, 0/4 nodes, ER+/PR-, HER2-
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Sep 16, 2009 07:53AM rreynolds1 wrote:

Hi Angelcakes,

My doc called to tell me I had breast cancer and said to call her office to schedule a bone scan, cat scan, and an ultrasound.  I asked why and she said that there was a part of the tumor that she didn't like.  Well, I didn't like ANY of that tumor but that really frightened me.  She said it was standard with tumors over 2 cmm.  As it turned out, mine was 1.8 cmm, node negative and Stage 1.  I'm glad I had the tests because I can be more confident about where it is in my body.  I would bring someone with you.  I didn't and I wish I did.  You won't find out the results for a few days.

Hugs.

Roseann

Roseann

Dx 2/2/2009, ILC, 1cm, Stage I, Grade 2, 0/3 nodes, ER+/PR-, HER2-
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Sep 16, 2009 08:35AM KathyNSW wrote:

Hi anglecakes

I had to have a bone scan, CT scan and blood tests before I had my mastectomy.

I am in Australia.

Take care

Kathy

Dx 8/6/2008, ILC, Stage II, Grade 2, 1/12 nodes, ER+/PR+, HER2-
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Sep 16, 2009 12:22PM newday1976 wrote:

Seyla 88, I was referring to the above poster that said it was standard of care in Ontario, when indeed it is NOT standard of care in Ontario.They wonder why our health care is costing so much.Under stage one with no nodes, I was told there was a 2% chance it had spread elsewear and that as I explained these tests often bring things up that are NOT cancer.

Ivorymom, you are right on the money, more discussion..I know exactly what is happening in my body I do not  regret for a moment not having the scans, what a waste of resources.

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Sep 16, 2009 12:31PM Tabatha00 wrote:

After I was diagnosed I had a CT w/contrast, bone scan, more mammo's and ultrasound of my axilla nodes.    I think it's standard procedure where I am getting treatment from.

Dx 5/22/2009, IDC, 2cm, Grade 3, ER-/PR-, HER2-
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Sep 16, 2009 01:01PM AnnNYC wrote:

My oncologist (who I believe to be one of the "top oncologists in New York") has never ordered a bone scan (Stage 1, 1 cm, no lymphovascular invasion, etc.) -- in fact, when I once mistakenly referred to my bone density test (which we in rheumatology call "a DEXA scan") as "my bone scan" she said with near-alarm "Who ordered a scan for you?!"  Her judgment is that it was unneeded/excessive in a case like mine.  I agree that it's a judgment call...

Dx 3/9/2007, IDC, <1cm, Stage I, Grade 2, 0/5 nodes, ER+/PR+, HER2-
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Sep 17, 2009 11:43AM swimangel72 wrote:

I know a woman on these boards who had routine scans with her Stage 1 tumor, and this was how they discovered it had already spread to her liver. When you have symptoms of problems (such as unexplained bone pain or pain near your ribs) I think it's important to get a scan. Even so-called Stage 1 tumors can metastatize - even before it's staged. Excessive - no - not for the one person who finds out she has mets. Frown

3/3/08 Right-side mastectomy with immediate muscle-sparing free tram; 3/9/08 Developed abdominal MRSA staph infection and hernia;Completed 4 months Navelbine and 1 year Herceptin; Arimidex - 3 more years! Diagnosed at age 53

Dx 2/5/2008, IDC, <1cm, Stage Ib, Grade 1, 0/7 nodes, ER+/PR+, HER2+
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Sep 17, 2009 01:05PM newday1976 wrote:

I do not recall anyone saying anything about NOT having scans for actual symptoms.Of course you should get whatever you need when you have pain.Geez

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Sep 18, 2009 04:02AM crazy4carrots wrote:

 After my surgery, the pathology determined that I had neither lymphatic NOR vascular invasion, and I think that's a fairly standard pathologic assessment.  So, with those two factors in the negative column, and with no other symptoms, why would I have needed a bone scan?

To follow by faith alone is to follow blindly -- Benjamin Franklin

Dx 1/10/2008, ILC, 1cm, Stage I, Grade 3, 0/4 nodes, ER+/PR-, HER2-
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Sep 18, 2009 04:15AM swimangel72 wrote:

Oops - my mistake Newsday - I just remembered - the woman who was Stage 1 and had a scan which showed liver mets did NOT have any symptoms or pain - even her doctors didn't believe at first that it was breast cancer. She had to find a liver specialist who biopsied the cyst which proved it was mets. Therefore, allow me to change my opinion - I believe that all women in ANY stage of breast cancer should get baseline scans - including MRI's of both breasts and bone scans. As SherriG pointed out - these scans are extremely useful for future comparisons. This is CANCER, for crying out loud - not an ear infection - this is a person's LIFE we are talking about. Geez.

3/3/08 Right-side mastectomy with immediate muscle-sparing free tram; 3/9/08 Developed abdominal MRSA staph infection and hernia;Completed 4 months Navelbine and 1 year Herceptin; Arimidex - 3 more years! Diagnosed at age 53

Dx 2/5/2008, IDC, <1cm, Stage Ib, Grade 1, 0/7 nodes, ER+/PR+, HER2+
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Sep 18, 2009 05:08AM, edited Sep 18, 2009 06:25AM by CapeBretongirl

Newday 1976; My oncologist was visiting my neighbors, who are also doctors. Before his visit, earlier that day, I gave my neighbors a copy of my 19 year old daughter's medical file.(she had recently been dx with terminal pancreatic cancer) I was looking for advice, a thread of hope, or anything that might help my family and me, cope with this horrendous news. My kind hearted neighbors ask my oncologist if he would go over to my home, and have a few words with me. I was sitting on my front veranda, on my laptop, reading this topic, when he came over. He sat down next to me and I ask him the question regarding bone scans. I typed in his reply. After reading your message yesterday morning, I questioned him during my afternoon appnt. He replied that the key word was recommend. A recommendation is not a command, it's a suggestion.

You are a very angry person, who is angry at the world, and are taking this anger out on this site. From this thread and previous ones I have been on, you have demonstrated difficulty in wording replies in a civil, polite manner etc. Many of your replies are confrontational. Some have snide comments that indicate, that you are looking for an argument. Insulting and insinuating that people are being dishonest, does not help you, or others. I wish you the best. And hope that you find a way to deal with the demons, you are obviously wrestling with. I hope your future posts will be helpful and healthy. I will not reply or see any of your further posts because I'm going to do what others have done, and hit the ignore this member button.

Dx 5/2008, 6cm+, Stage IV, Grade 3, 1/8 nodes, ER+/PR+, HER2-
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Sep 18, 2009 05:44AM swimangel72 wrote:

Hi Dawn - I also firmly believe that "every one's life is equal"..............and yet I do believe that millions of dollars are wasted, but NOT on breast cancer patients. Sorry for my strong opinion...........let's save money in the health care system in other areas...........but breast cancer patients need all the help they can get. And yes - I DO have excellent insurance - but it costs my DH and me an arm and a leg, sigh.........if you were one of the unlucky 2% to have mets upon diagnosis, how would you even be aware of that fact if scans were not performed? I believe studies will prove that baseline scans can help individualize treatments for BC patients and thus help PREVENT many of the recurrences and mets that now ROUTINELY occur!

Sorry everyone - I am not trying to hyjack this thread and turn it political ..........if a doctor thinks a scan is necessary, even for a Stage 0 patient, then so be it, the Insurance Companies should pay. What price do we put on a person's life?

------------------------------------------------------------------------------------------------------------------------------------

A STARFISH STORY"
A man was walking along the beach one evening and saw a little boy throwing starfish that had been washed ashore by the tide into the sea. He thought the boy was silly in trying to save the starfish, as he knew it was impossible to throw every single one of the starfish back into the sea, with the tides washing them up.
The man walked right up to the boy and asked him why he was trying to save the starfish.
"You see sir; the starfish would die if they are left on the shore. They need to be in the sea in order to live," answered the boy with all the innocence of a child.
"But son, how are you going to save all of them? Every time you put one back, another would be washed up. It doesn't matter to them, son."
The boy picked up a starfish, looked at the man and said, "But sir, it matters to this one." After saying that, he threw the starfish back into the sea.

3/3/08 Right-side mastectomy with immediate muscle-sparing free tram; 3/9/08 Developed abdominal MRSA staph infection and hernia;Completed 4 months Navelbine and 1 year Herceptin; Arimidex - 3 more years! Diagnosed at age 53

Dx 2/5/2008, IDC, <1cm, Stage Ib, Grade 1, 0/7 nodes, ER+/PR+, HER2+
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Sep 18, 2009 06:16AM CapeBretongirl wrote:

Dear Swimangel72;  My Dmom was first diagnosed with stage 0 bc.  The doctor sent her for a bone scan and other tests in spite of this.  He believes that bc is so unpredictable, that he sends all of his newly diagnosed bc patients for these tests.  The results of the tests put her at Stage IV.   Take care.
Dx 5/2008, 6cm+, Stage IV, Grade 3, 1/8 nodes, ER+/PR+, HER2-
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Sep 18, 2009 06:20AM CapeBretongirl wrote:

Dear Dawnn;  You are so rignt, I wish there was an easy answer.  All cancer is sh%ty.  Take care.
Dx 5/2008, 6cm+, Stage IV, Grade 3, 1/8 nodes, ER+/PR+, HER2-
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Sep 18, 2009 08:52AM, edited Sep 18, 2009 09:36AM by Chickadee

I just finished up several days at MD Anderson (#1 Cancer Center in US according to US News&World). Maybe their practices has some bearing on this discussion. I can only speak for my situation.  They ordered a bone scan as part of my workup.  They told me during registration that a schedule of tests had already been set up for me but that I should not make plans based on the tests as the Dr. may add or remove tests once he reviewed all my tests and info from the original diagnosing center. I'm going to side with believing there is value in this test.  He did not schedule a breast MRI which surprised me as so many of you seem to have had that as a matter of course.  So I am fairly confident that the tests chosen were made partly as standard practice but with the understanding that the Dr. would have the last word on what tests he wanted.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012

Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Sep 19, 2009 04:18AM QueenK wrote:

Dawnn, I have a feeling that I agree with you.I think we should all really go with what our doctors suggest. I really think it is kind of a put down when someone says "I know I did everything I could".Every case is individual and if your oncologist sent you for scans,fine.If someone elses did not, maybe there was a reason.

These blankets statements do not help anyone.We are all doing the best we can with the guidance from our practitioners.

I did not have scans either.My oncologists take is that it opens up a huge can of worms.Such as seeing things like scarring that are not related to breast cancer.

Anyway

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