The role of computed tomography in the detection of bone metastases in breast cancer patients.

Computed tomography (CT) of bone was carried out in 20 patients with breast cancer, all of whom had abnormal radionuclide uptake on skeletal scintigrams but normal conventional radiographs. Twenty-eight sites were examined and 13 showed metastases in 11 patients. Five of these patients had no evidence of extra-skeletal recurrent disease. Follow-up at eight of these sites showed healing, sclerosis or progression, all of which correlated well with clinical findings. CT showed benign causes of radionuclide accumulation in three patients (7 sites) but no abnormality in six patients (8 sites). None of these patients has subsequently developed bone metastases. CT is superior to conventional radiographs in the diagnosis of skeletal metastases and should be carried out when skeletal scintigraphy is positive and conventional examinations are normal.