Breast Cancer/Bone Scan

[mobetsis]

My sister is scheduled to have a radical mastectomy on Octber 31st. Can you please tell me, what is the normal procedure for having a bone scan and a CAT scan done? Is it done before the surgery or after the surgery? They will be doing breast augmentation at the same time, and I seem to remember my Mother having the scan done before her surgery. Also, who orders the tests? Is it her Doctor, Surgeon or another Specialist?
We are very concerned about this issue. Any other insight you can give me would be greately appreciated. Thank you so much!

[barbie334]

A related discussion, cancer return was started.

[shubunkin]

I have been doing alot of reading on tumors and what they thrive off of. I wanted to get a doctors perspective. They say that tumors feed off sugar. And if you deprive them of it SOMETIMES they reduce and sometimes dissappear. What is your take on this. There was a man I read about on the internet that had colon cancer and he went on a very strict diet of no meat and 85% raw 15% cooked foods. Thankyou, Danielle

[surgeon]

There really isn't a standard protocol: I'd say it's most common to do supplemental testing after the surgery. It depends on the final report: if the nodes are involved, then such testing would definately be done. If the tumor has particularly aggressive characteristics, then sometimes such testing would be done, even if the nodes are ok. To do extensive screening for all women before that info is available is felt by most to be cost-ineffective; most would not feel such testing is necessary if the above-referenced data are ok. Some docs want to do those tests on all women no matter what. And in the case of immediate reconstruction, depending a bit on the type chosen, some would argue that before embarking on that path, it's worthwhile to know if the other tests are ok, because if they're not, one might consider deferring the reconstruction. These are grey zones, and need individualization.

[surgeon]

The internet and other media are full of anecdotal stories and ideas based on them. There's no science behind any dietary effects on cancer which is already present (although there's some evidence of prevention based on some dietary measures.) As to sugar: the sugar level in your blood remains pretty constant unless you are diabetic, and a tumor or any other living cell in your body gets its sugar from the blood. So no matter what you eat, a tumor will be exposed to a constant level of sugar. If you were to succeed in lowering the sugar level in your blood, you'd either become weak or pass out.

[CCF-RN,MSN-JS]

Dear mobetsis, The decision about whether or not, or when to do staging scans depends on different things such as tumor size, lymph node status, features of the tumor - more or less aggressive looking under the microscope.

A bone scan and ct scans are not necessarily always done.  If the tumor at biopsy is large, or some of the features of the tumor make it more suspicious for a possibility of spread they may do these staging studies before surgery.  If there is a small tumor, no positive lymph nodes after surgery they may decide that these studies are not necessary.  

Any of the above doctors could order the staging studies if they were felt to be necessary, often it would be the medical oncologist who does so.