Breast Cancer - 49-year-old female for staging of breast carcinoma

History
49-year-old female for staging of breast carcinoma

PET/CT Findings
This examination demonstrates innumerable areas of bony metastatic disease seen throughout the cervicothoracic and lumbar spine, the pelvis, bilateral ribs, and the proximal appendicular skeleton bilaterally. There are several lytic areas seen within the thoracolumbar spine and there may well be developing insufficiency fractures seen near the thoracolumbar junction. Both proximal femurs are involved, more prominently on the left. The patient’s primary malignancy in the lateral aspect of the right breast is demonstrated and shows hypermetabolic activity. There are three hypermetabolic right axillary lymph nodes, the largest of which measures in the 2-centimeter range. No abnormal activity is seen within the left breast. No definite sings of pulmonary metastatic disease or hepatic disease is appreciated.

Impression
The findings of this exam are consistent with a primary right breast malignancy described at the 9 o’clock position on previous reports with evidence of local metastatic disease involving the right axilla and extensive bony metastatic disease as described, including bilateral ribs, the entire spine, pelvis, the proximal humerus bilaterally, and the proximal femurs as described above.

Dosage
9.6 mCi FDG

Courtesy of
Thompson Cancer Center