sacral mets

I am 7 1/2 years post mastectomy and chemo, tamoxifen.  markers started rising then arimidex now aromasin  and zometa.  I had a pet scan which shoed something on scaral spine.  bone and cat were negative.  MRI report us as follow.  there is a moderate sized area of marrow replacement in the distal sacrum, both in the midline and in the left sacrum, seen as hypointenas signals on T1 and hypeintense onT2 weighting and inversion recovery, with enhancement after IV Gadplonium.  There is no associated soft tissue mass and no break through into the sacral canal. No free sacral mass.  Imp.  sacral mets.What does this mean??  Is the cancer in my marrow  and likely to spread rapidly through it? Is this something that can be controlled for  some time  or should I get affairs in order?   If there is aromasin failure  what is the next step?  I feel fine and if it weren't for the 27-29 marker rising to 100  I would have no clue this is going on.   Would radiation to the area be indicated?  Appreciate any help as right now all my positive thinkuing has left me. Does one ever survive this kind of mets?  Read that there is a 10-20% long time survival in some cases.Is this the area of mets than can be treated with some sort of disease free interval?

[CCF-RN,MSN-rf]

Dear omacar:  It sounds as though you have a small area of breast cancer that has spread to the bone (sacrum).  You are already being treated for this with the zometa.  This does not mean the cancer is necessarily in your bone marrow.  However, it may mean that there are microscopic cells in your body.  Hopefully the aromasin will address this.  People can and do live for a long time (years) with this type of problem.  Of course, no one really knows how long a person will live.  Radiation therapy is usually offered if there is pain associated with the metastasis.  As you are without any symptoms and are already being treated, most would observe for now.

[surgeon]

of course, the best source of info is from your oncologist, since every case has its own special considerations. But the scan suggests there's tumor in the sacral marrow. If that's the only location, radiation can be a consideration. Long-term survival is still possible, but cure is very unlikely.

[simbee]

A related discussion, sacral biopsy was started.