When a breast cancer has been diagnosed, some people have a bone scan to stage the breast cancer.
Staging tells the doctor how big a cancer is and whether it has spread. Knowing the stage helps your doctor decide which treatment you need.
You might have a bone scan if:
- there are cancer cells in the lymph nodes under your arm (axilla)
- you have a larger breast cancer, for example bigger than 5 cm
- you have specific symptoms, for example bone pain
What is a bone scan?
A bone scan shows up changes or abnormalities in the bones. It is also called:
- a radionuclide scan
- bone scintigraphy
- nuclear medicine bone scan
A bone scan can look at a particular joint or bone. In cancer it is more usual to scan the whole body.
A large camera (called a gamma camera) scans you and picks up radioactivity.
You have the scan in either the medical physics, nuclear medicine or x-ray department at the hospital. The scan can take between 30 to 60 minutes, but you'll be at the hospital for several hours.
If there are changes on the scan they may be called hot spots. These are not always cancer. Bone changes can happen for other reasons like arthritis. You might need to have a CT scan to know exactly where these abnormal areas are.
Preparing for your bone scan
You can eat and drink normally before your scan. Take your medicines as normal unless your doctor tells you otherwise.
Phone the department where you are having the scan if you are pregnant or breastfeeding. You might have to stop breastfeeding for a short period of time after having the scan. So you might want to store enough expressed milk for 1 or 2 feeds beforehand. The staff at the department will advise you.
You have to arrive at the hospital about 4 hours before your scan. Your appointment letter will tell you the exact time.
Tell the department beforehand if you have difficulties passing urine, need to pass urine urgently, or have prostate related problems.
When you arrive at the department the radiographer explains what will happen and asks you to sign a consent form. You can ask them questions if anything is unclear.
They give you an injection of a radioactive liquid called a radionuclide or radioactive tracer. They inject it through a small tube (cannula) in a vein in your arm or back of your hand. It’s a small amount of radiation.
The injection might make you feel hot and flushed for a minute or two but this is normal.
You might have a test scan immediately after the injection, but normally you wait 2 to 3 hours while the radioactive tracer travels through the blood and collects in your bones.
The radioactive tracer tends to collect more in areas where the bone is breaking down and repairing itself. These areas of activity (called hot spots) show up on the scan. They look darker than other areas of bone.
Waiting for the scan
Your radiographer will ask you to drink plenty of fluids while you wait for your scan. This flushes the radionucleotide round your system well.
You might be able to walk in the hospital grounds while you are waiting. Or you might need to wait in a separate area with other people having nuclear medicine tests. You might need to use specific labelled toilets.
The radiographer will ask you to pass urine just before your scan. This gets rid of any radionucleotide in your bladder, so it doesn’t interfere with your scan.
Take a look at this is a short video about having a bone scan.
A bone scan looks for abnormal areas in your bones. Before your scan you have an injection of a small amount of radioactive substance. This is not enough to be harmful.
After the injection you can leave the department for a couple of hours. This allows the substance time to get to your bones. The nurse will tell you when to return to the department.
While you are away drink a couple of extra pints of water to flush the injection through your body. Before the scan you will need to empty your bladder.
The camera passes very close to you but doesn’t touch you. It takes a series of pictures.
The radioactive substance helps to show up abnormalities in the bone. These could be a number of different conditions including cancer and fractures.
The scan takes between thirty minutes and an hour. You can leave once it’s finished.
The small amount of radioactivity left in your body disappears within the next 24 hours. So during this time avoid close contact with babies, children and pregnant women.
You usually get the results within a couple of weeks.
Having the bone scan
You usually wear your own clothes for the scan but some hospitals may ask you to change into a hospital gown. Your radiographer will ask you to empty your pockets and remove any metal objects such as keys, coins, belts, braces and jewellery.
You lie down on a couch and have to keep very still while you go through the scanner. The camera takes pictures of the bones in your whole body.
Let your radiographer know beforehand if you think this will be a problem for you. Tell them if you start to feel closed in or claustrophobic. They can help to reassure you.
The scan can take between 30 minutes to an hour.
After your bone scan
You should be able to go home soon after the scan. You need to drink plenty for the rest of the day to help flush the radioactive tracer out of your body. Your body gets rid of it through the urine, usually within 24 hours.
A very small amount of radioactive tracer is left in your body for a short time after your scan. So for the rest of the day keep any time you spend within arm's length of pregnant women, babies or young children as short as possible.
Getting your results
You should get your results within 1 or 2 weeks at a follow up appointment.
Waiting for test results can be a very worrying time. You might have contact details for a specialist nurse who you can contact for information if you need to. It can help to talk to a close friend or relative about how you feel.
Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.
A bone scan is a safe test for most people but like all medical tests there are possible risks. Your doctor and radiographer make sure the benefits of having the test outweigh these risks.
Bruising and swelling
You might get a small bruise around the area where they put the needle in.
There is a risk that the radioactive tracer will leak outside the vein. This can cause swelling and pain in your arm, but it's rare and gets better quickly.
Contact the department if you are due to have a bone scan and you are pregnant or breastfeeding. The staff will tell you if you need to stop breastfeeding for a time after having the radioactive tracer.
You might not be able to have a bone scan if there is a possibility that you might be pregnant. This is because the radioactive tracer could affect the developing baby.
Exposure to radiation during a bone scan can slightly increase your risk of developing cancer in the future. Talk to your doctor or radiographer if this worries you.