Radiographic evaluation of therapeutic response in bony metastases of breast cancer.

Response to chemotherapy was evaluated in 50 previously untreated patients with bony metastases of breast cancer. Lytic metastases respond in a definite sequence: sclerotic rim, filling-in, uniformly blastic, uniform fading. Increase in size of lytic areas of destruction in previously responding areas signals worsening. Mixed metastases are considered as beginning with a sclerotic rim. Response is otherwise similar. Particular attention is paid to the lytic areas. Blastic metastases are considered as beginning at the uniformly blastic stage. Progression is marked by a volumetric increase in blastic change or destruction in blastic regions. Change occurs slowly. Review of multiple studies is often necessary to reach the correct conclusion and clinical history is necessary.