Bone scan question

My 67-year-old mother has breast cancer with metastases to the liver and lungs. I'm concerned that her oncologist won't order a bone scan to check for bone mets. She has had some hip pain, but the doctor doesn't think the pain is severe enough to pursue. He ordered an X-ray, but he didn't see cancer there. I might add that mom had a cough for 6 months before a CT scan was ordered and the lung nodules did not show up on X-ray. Her last bone scan was in 1997 with her original diagnosis. Is it reasonable not to order a bone scan or should we insist? Thank you.

[CCF-RN,MSN-rf]

Dear Tessrose:  If it has been three years since she has had a bone scan and she is having new pain, it is reasonable to do a bone scan.  Especially since she has metastatic disease already.

[surgeon]

with metastases in liver and lung, the goals at this point are symptom control, managing quality of life issues; anti-tumor therapies may still be useful if they can be shown to be holding the tumors in check to some degree. So as to hip pain: if it's controlled adequately by whatever means it's not relevant to the overall picture what a bone scan would look like. If pain were not being controlled, and if radiation to the area would be a consideration for pain management if it were found to be due to cancer, then a bone scan might be a consideration.