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Old 06-08-2011
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Question Breast cancer history and now comes with back pain

what is the best next step guys?


is it Bone Scan? or MRI? obviously we are thinking Mets, but it also could be other things (like herniation of the disc etc) so you think MRI is adequate for mets? Is MRI best next step?
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Old 06-09-2011
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Default Quick, non-invasive and cheap

Hi there,

I agree that we need to have low threshold for bone mets.

However though back pain is very commonly associated with degererative diseasess, disc problem etc.

And the question is "next", not "definitive test".

I probably go for X ray first which is quick, non-invasive and cheap!

Looking forward to hearing the correct answer!
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Old 06-09-2011
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Although MRI is quite sensitive in detecting bone mets.
MRI is estimated to cost 2-3 times as much as Tc bone scintigraphy.
Bone scintigraphy is considered the best test because we usually have to screen the whole body and it is very reliable in picking up bony mets.
http://emedicine.medscape.com/articl...0-overview#a23

But if the question says the best next step, then I would agree with 1TA2B as X-ray is quick, easy and very cheap.
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