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00200_Field_SRC.c06.A.45.txt
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1997-01-28
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• Measuring response in bone lesions takes longer and is more difficult because most metastatic breast cancers
produce a softening or dissolving of the bone with the appearance of a "lytic" spot that looks like a hole. If
treatment is successful, the lytic lesion will fill in with new bone, but this takes many months.
For determining the response to chemotherapy or hormonal therapy, a bone lesion that has not received
radiation therapy has to be chosen as a marker. Obviously, if a lesion given radiation heals and hormone
therapy or chemotherapy is also being given, it would be impossible to know which treatment brought about
the healing.
Bone lesions require that an x-ray be done before treatment and another as soon as the treatment has been
given an adequate trial.
Following bone scans for evidence of response to treatment may not be as useful as conventional x-rays of
lytic bone lesions. Scans may show "hot spots" in any abnormal area, and these spots may also indicate
healing. They may also be produced by inflammation , metabolic diseases or severe arthritis. The area could
remain positive for months or a few years with successful therapy.
In a few patients with positive bone scans but without any lesions on x-rays, response may be signified by
no new lesions developing. If the bone scan is unchanged after six months, especially if pain lessens, the
positive areas can be presumed to indicate healing.
• In some breast cancer patients, the bone lesions themselves produce extra bone (blastic lesions) instead of
"holes" in the bone (lytic lesions). Here it is not possible to determine healing by looking at x-rays because