Thomsen H S, Lund J O, Munck O, Andersen K W, Støckel M, Rossing N
Eur J Cancer Clin Oncol. 1984 Aug;20(8):1019-23. doi: 10.1016/0277-5379(84)90103-2.
In 1978 and 1979, 1060 Danish patients with primary operable breast cancer were bone-scanned for osseous metastases before entering a nationwide therapeutical trial. A re-reading group interpreted the scans produced in 12 participating hospitals. As a consequence standardized guide-lines for interpretation were agreed upon from 1979. The frequency of positive bone scans suggesting bone metastases fell abruptly from 1978 to 1979, as read both locally and by the re-reading group. As measured statistically the difference between the interpretation of the local and the re-reading groups remained unchanged. Of the 1060 patients 760 were followed by repeated pre-scheduled scans 6 and 12 months after surgery until any kind of recurrence was diagnosed. Only 37 of the 760 patients (4.9%) developed bone metastases verified by radiology or autopsy during the first 2 yr after surgery. A single positive scan, especially performed 6 or 12 months after surgery, as well as two or three scans repeatedly staying or becoming positive increase significantly the risk of developing bone metastases within 12 months after the latest scan. In 13 of the 37 patients with otherwise subsequently proven bone metastases the latest scan(s) were negative. It is concluded that a fixed schedule of repeated bone scans in patients with breast cancer is not warranted.
1978年和1979年，1060名患有原发性可手术乳腺癌的丹麦患者在进入一项全国性治疗试验之前，接受了骨扫描以检查骨转移情况。一个重新解读小组对12家参与研究的医院所做的扫描结果进行了解读。因此，从1979年起就商定了标准化的解读指南。从1978年到1979年，无论是本地解读还是重新解读小组的解读，提示骨转移的阳性骨扫描频率都急剧下降。经统计学测量，本地解读小组和重新解读小组的解读差异保持不变。1060名患者中，760名在手术后6个月和12个月按照预定计划进行了重复扫描，直至诊断出任何类型的复发。在760名患者中，只有37名（4.9%）在手术后的头2年出现了经放射学或尸检证实的骨转移。单次阳性扫描，尤其是在手术后6个月或12个月进行的扫描，以及两三次扫描持续呈阳性或转为阳性，会显著增加在最近一次扫描后12个月内发生骨转移的风险。在37名后来被证实有骨转移的患者中，有13名患者的最近一次扫描结果为阴性。得出的结论是，对乳腺癌患者进行固定计划的重复骨扫描是没有必要的。
