how accurate is an x-ray for bone mets

[katarina777]

I have IBC, or had it, and finished treatment about three months ago. I have had so many strange and unfamiliar and worsening problems in my left arm and right leg, I am very worried that this is bone metastasis. Last week, it came on suddenly in my right leg, and I was not able to walk normally;  limping, my foot kept on falling to the right side, pain, swelling. (I had an ultrasound to rule out blood clots and an x-ray, and both were negative) Last night, I just got up from a chair and my right leg sort of crumbled, or deflated, and I fell from the weakness. I have since not been able to walk at all; I cannot put any weight on the leg, and it felt like it was broken/braking.  (this is now better) pretty severe pain, and especially in the back of the knee. Some swelling.
My question: Is it true that almost half of a long bone must have been destroyed before it shows up on an x-ray for bone mets? because my doctor sees the negative result of the x-ray as 'case closed'. but I cannot ignore such extreme, unfamiliar and bizarre symptoms. What should I ask the doctor, and how would I go about justifying a bone scan to her? (if you agree that this test is reasonable for me to have) My tumor was very large, and very invasive and many lymph nodes positive which was found during surgery but not on any diagnostic tests. I am very anxious about all of this.

[Dennis MD]

Hi Katarina,
How are you doing?  I have some clarifications.  When were you diagnosed with inflammatory breast cancer?  What sort of treatment/s did you undergo?  Are you currently taking any medications?
In the setting of breast cancer, a possible metastasis is always entertained when a patient develops new or worsening symptoms, unless proven otherwise.  In your case, you were not experiencing bone pains previously.  I believe you should undergo further examinations to rule out possible bone metastasis.  A total body bone scan can be done to check for possible bone metastasis.  If the bone scan turns out to be negative or normal, you still need to determine the cause of the bone pains.  Perhaps it is secondary to a medication that you may be taking (especially if you are taking an aromatase inhibitor).  Even if your x-ray result is negative, you should undergo further examinations to determine the cause of the bone pains.
Hope this helps.
God bless you.

[katarina777]

Thank you, Doctor Dennis, for engaging with me.  I also want you to know that I have done my homework before asking you about this.
I was diagnosed in June, 07. A tumor the size 9x 10 cm was found, and it came in a couple of week's time.
I had eight cycles of cytoxan, adriamycin and taxol. The tumor shrunk a lot but during surgery it came out that  about 18 lymph nodes had been cancerous, and some had grown back, others were not killed by chemo, and the cancer had spread into adjacent fatty tissue and it stuck to nerves and some stuck together. I had  the entire right breast and lymph nodes and skin over the pectoral muscle removed. None of the lymph nodes ever showed up on MRI, and they had not been palpable.

I had surgery six weeks after my last chemo and I  think they waited too long. This was followed several weeks later by about 33 radiation treatments to the right chest wall and further under the arm.
I started Tamoxifen, I had bone pain in my arm on and off for a couple of weeks and it then went away.

I already had problems with my arms at diagnosis and limited mobility and this cleared up with the chemo. it came back after the chemo ended.

But the symptoms of bone pain, first in my left arm, (the operation was on the other side) and shoulder and then going into the right leg, this all started a few days after I had the portacath removed. The procedure itself was completely painless. (I was afraid maybe it spread through the skin in my case)

It started on and off, and worse without activity and is now constant, and worst in my leg, and with activity and without. very deep and dull, unfamiliar pain, and sometimes I now feel it in the groin and hip as well and today in the middle of my spine, but only for a short time.  I have had no back-pain since I started chemo but that was lower in the back.

I also have other chronic problems like 33-years of insulin dependent diabetes, high BP, hypo thyroid, (treated) and some progressive kidney problems.

But this with my left arm and leg is totally foreign to me and new and bizarre, just like the course with the IBC coming on so fast.

My oncologist told me I was at extremely high risk for reoccurrence and metastasis but when i have called, his nurse just reassures me that it's nothing, so now I contacted my GP. They took some blood tests today, and I asked for a bone scan, which I have never had. My doctor has not let me know if she is willing to do one. She only told me today that I was to have my blood drawn.

My oncologist also told me more than once that when the cancer came back in any form or way, there was nothing he could do to treat it, or that would work. I suspected his opinion was based ion the combination of my specific cancer, (estrogen pos. but her negative), my general health, and that you can only give so much of chemo, and that all else was already done. he also said the Tamoxifen was more for the doctor's own comfort, and that they could feel better about doing something else. No history of cancer in my family. I am 49.

Thank you for listening. Kat

[katarina777]

I forgot to leave your name before in the to: box. Also, i only had 6 chemo treatments, not 8. Thanks.

[redmal]

Can you possibly get yourself another opinion from a different oncologist?  I have bone mets (widespread-spine hips legs arms ribs) and chest