Skeletal metastases

Clinical scenario

Middle aged woman, operated breast carcinoma and multiple post operative chemotherapy cycles presenting with severe low back ache.

CT low back


Multiple lytic and sclerotic bony lesions are seen involving anterior and posterior elements of dorsal and lumbar vertebrae as well as scattered in the pelvic bones. No secondary spinal canal stenosis.


Most common route of spread of infection / neoplasm to the spine is through the vertebral venous plexus. Breast metastasis in general tend to be lytic, once treated / partially treated have a more sclerotic appearance. The importance of pathological bony fractures and secondary spinal canal stenosis needs to be watched out for.

Read more

  1. Skeletal metastases – Radiopaedia
  2. Tateishi, Ukihide, et al. “Bone metastases in patients with metastatic breast cancer: morphologic and metabolic monitoring of response to systemic therapy with integrated PET/CT.” Radiology 247.1 (2008): 189-196.
  3. Lee, Sandy C., et al. “Radiologist’s role in breast cancer staging: providing key information for clinicians.” Radiographics 34.2 (2014): 330-342.