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is it really a bone island?

I was diagnosed with DCIS in March 2015 and had a bilateral mastectomy and TE reconstruction.

I've recently had a breast MRI, a nuclear bone scan, and a CT scan of my abdomen. The breast MRI was completely normal. The bone scan showed: "There is mild heterogeneous uptake in the right shoulder, sternum, cervical spine, mid lumbar spine, and bilateral SI joints which likely represents degenerative changes."

The CT scan showed: "MUSCULOSKELETAL: Stable small escorted foci in bilateral femoral head and left pubic ramus, most likely benign bone island. No suspicious bony lesion is identified." That happens to be the spot where I'm having significant pain, which led to the bone scan and CT (as well as other weird symptoms I had before my diagnosis).

In 2015, during treatment for DCIS, a tumor was found in my left calf. It was benign, but I had a CT with contrast done of my entire right leg and there was no mention of a bone island. Thereafter in 2019, for issues unrelated to cancer, I had a CT scan with contrast of my abdomen and musculoskeletal was normal.

From what I've read, no treatment is necessary for a bone island unless (1) it causes pain or (2) the patient has a history of cancer. I meet both of those factors. My breast surgical oncologist does not seem concerned because she says the bone scan was normal. I've asked to see an orthopedic doctor and she is going to make a referral for me.

I'm just worried that this is not actually a bone island because it is just now showing up and is causing pain, which is unusual for bone islands, and especially in light of some other symptoms I've been having.

Has anyone had anything similar happen? How did it turn out?

Comments

  • maggie15
    maggie15 Member Posts: 1,316

    trailheather, I had a bone island show up on my most recent chest CT for lung nodule surveillance. It was in the scapula behind my bc breast which has been consistently painful for the two years since surgery and radiation. Sometimes radiologists don't mention bone islands since they are benign. This was the third CT for the same purpose and the report said that the bone island size was stable so it must have been present but not commented on before. My doctor thinks that my pain is caused by nerve damage and has nothing to do with the bone island even though it is in the same general area.

    Bone islands are hard pieces of bone in an area of softer bone and do not look like mets to radiologists. The "radiodensity", light vs dark contrast, is different. Since you still have questions it is good an ortho is following up on this. I hope it remains a bone island and they can figure out the cause of your pain. Let us know how it turns out.


  • trailheather
    trailheather Member Posts: 2

    maggie15, thank you so much for your response. I went back to look at my CT report and it does say that a comparison was used from 2019 when I had my last abdominal CT scan, so it appears that mine also was present back then but not commented on.

    What I really need to do is stop googling. :/