Bone metastases

I had invasive ductal cancer dx Jan 2003 stage and grade 2, 2 cm- WLE sample node removal, then total axillary; 3/18 nodes positive. 6 x FEC, 45 grys rads, on Arimidex for one year.
I have been having hip pain for 9 months particularly when lying down in bed. Have see my GP who did alkaline phosphatase blood test and normal x-ray - both normal. I am now seeing a physio as she can only rotate my left hip 50%. Arthritis has been ruled out.
Can the blood test and normal x-ray show bone metastases, or is a bone scan necessary? Can the Arimidex cause this pain? - it is not any better with the physio.
Also, my path report only showed ER status (+) - what is the relevance of PR and HER2 status and do I need to have this done?
Thank you, Liz.

[CCF-RN,MSN-rf]

Dear lizziec:  A plain x-ray of the hip only shows advanced bone
loss if there are cancer metastases. A bone scan may be a more sensitive test, but may not detect bone metastases if there is not sufficient bone inflammation yet.  An alkaline phosphatase test is a non-specific enzyme that would likely be elevated if there was significant bone damage. Certainly, joint pain is one of the documented side effects of Arimidex. However it can also be an early sign of bone metastases.  In addition to seeing your GP, it may be worth reviewing all of your symptoms with your oncologist who will have a good overall perspective in dealing with the side effect profile of taking Arimidex as well as testing for any possible bone metastases.  In terms of the ER status, a positive indicates that your tumor may be "fed" by estrogen.  Certainly the PR status would be done when the ER was done.  HER2 is a test looking for receptors that are found on some breast tumors.  You should discuss with your oncologist whether this was done when you were diagnosed and the value of doing it now if it was not.

[mjaclis]

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