Bone scintigraphy screening in stage I—II breast cancer: Is it cost-effective?
GARY S. HOFFMAN, MD
KATHRYN A. WIKENHEISER, PhD
EDWARD B. SILBERSTEIN, MDAddress reprint requests to E.B.S., University of Cincinnati Medical Center, Mail Location 0577, P.O. Box 670577, Cincinnati, OH 45267-0577.
It is recommended that routine bone scans not be adopted for follow-up of patients with stage I—II breast cancer. Bone scintigraphy should be reserved for evaluation of patients presenting with symptoms suggestive of bone metastases.KEY POINTS
Bone scintigraphy as a screening modality for the detection of recurrent disease in patients with stage I—II breast cancer is not effective in prolonging patient survival or enhancing quality of life based on current scientific data. In addition, bone scintigraphic screening results in a significant cost to health care. Available data suggest that clinical follow-up is currently the best approach in detecting recurrent breast cancer. The data also show that 5-year survival is not prolonged in patients diagnosed by bone scan as part of an intensive follow-up scheme vs those followed by histories, physical examinations, and mammograms. Physician time spent in patient education may be a more cost-effective approach to patient follow-up than routine bone scans.