Understanding scan reports in metastatic breast cancer

In metastatic breast cancer, scans such as CT, PET-CT, bone scans and MRI are repeated every few months to see how the cancer is responding to treatment. The report is written by a radiologist for your oncologist, so it uses technical language that can be confusing and frightening to read on your own. Most reports compare the new scan with the previous one and describe whether known areas of cancer have shrunk, stayed the same or grown, and whether any new areas have appeared. Your oncologist then combines this with your symptoms, blood tests and examination to decide whether treatment is working. Broadly, results fall into four groups: complete response, where visible cancer has disappeared; partial response, where it has shrunk; stable disease, where there is little change; and progressive disease, where cancer has grown or spread. Stable disease is often a good result in metastatic breast cancer, because keeping cancer under control is a key aim of treatment. Some findings, such as a new small nodule or a bone change, may not be cancer at all.

The parts of a report

Most reports include the reason for the scan, the technique, a comparison with previous scans, detailed findings organ by organ, and an impression or conclusion summarising the key points.

Read the conclusion with your doctor

The impression section is the most useful part, but it still needs to be interpreted alongside your overall situation.

Receiving reports before appointments

If you receive a report before seeing your doctor, try not to draw conclusions until you can discuss it.

Scans are powerful tools, but they are not perfect, and reports need interpretation in context.

Small spots may be uncertain

Very small nodules in the lung or liver are often too small to characterise and may be harmless. They are usually watched on the next scan.

Healing can look like growth

Bone metastases responding to treatment can look brighter or larger on bone scans for a few months, known as a flare.

Inflammation can mislead

Infection, recent radiation, surgery or vaccines can make areas light up on PET-CT.

Different scans are hard to compare

Comparing a PET-CT with an earlier CT, or scans from different centres, can be less precise. Bring previous scan discs to appointments.

What this page cannot tell you

It cannot read your report. Ask your oncologist to explain the conclusion.

The days before and after a scan can be some of the hardest in metastatic breast cancer. Many people call this scanxiety.

Plan when to hear results

Ask whether your appointment can be arranged soon after the scan, so the waiting time is shorter.

Bring support

Take a relative or friend to the results appointment to listen and ask questions.

Avoid reading alone at night

If you receive the report early, set it aside until you can discuss it, or call the team if something worries you.

Talk about it

Counsellors and support groups can help you manage the stress of repeated scans.

Knowing what to expect on the day makes scans quicker and results more reliable.

CT scan

You may be asked not to eat for a few hours and to drink a contrast liquid. A contrast injection through a vein can give a brief warm feeling. Tell the team about kidney problems, diabetes medicines or previous reactions to contrast.

PET-CT scan

You usually fast for several hours and avoid heavy exercise the day before, because muscles and food affect sugar uptake. People with diabetes need specific advice on medicines and meals. After the injection you rest quietly before the scan.

Bone scan

A small injection is given, followed by a wait of a few hours while it travels to the bones. Drinking water and emptying your bladder often helps.

MRI

Tell the team about pacemakers, metal implants or fear of enclosed spaces. The machine is noisy, and earplugs or headphones are offered.

After the scan

Most people can eat, drink and return to normal activities straight away. After PET-CT or bone scans, drinking extra water helps clear the tracer, and staying away from pregnant women and small children for a few hours may be advised.

What to bring

Bring previous scan discs and reports, a list of medicines, and details of any recent surgery, radiation or infections.