DISTRIBUTION OF SKELETAL METASTASES - A BONE-SCAN STUDY OF 376 CASES

Technetium 99m methylene bisphosphonate bone scans of 376 patients wit h cancers of breast, prostate, lung, kidney, colon, and bladder and EN T cancer were reviewed, and the distribution of skeletal metastases wa s analyzed. Differences were not significant for rank order of metasta tic involvement in 9 selected regions in any cancer, but the breast ca rcinoma. Patients with breast cancer had less pelvis and more skull in volvement. The rate of skull metastases was significantly higher in br east cancer than in prostatic (p < 0.001), lung (p < 0.01) and kidney (p < 0.05) cancers. These results are weakly demonstrative of a role o f the vertebral veins in hematogenous spread of breast and prostrate c ancer. The hypothesis is proposed that this pattern of dissemination, which is suggested by experimental and clinical features, is poorly pe rceptible in the distribution pattern of skeletal metastases because o f the concurrent arterial spread of breast and prostatic tumors cells, which is likely preponderant.