Which statement about lytic bone lesions in an older patient with weight loss is true?

Which statement about lytic bone lesions in an older patient with weight loss is true?

• A. Breast cancer commonly causes lytic lesions
• B. Dexa scans are indicated for lytic lesions
• C. Lytic lesions never indicate malignancy
• D. Osteoporosis is the most common cause of lytic lesions

Answer: (A)

Lytic bone lesions reflect destructive bone activity, often due to malignancy spreading to bone or to conditions like multiple myeloma. In an older patient with weight loss, new focal bone destruction is most concerning for metastatic cancer rather than benign bone loss. Among cancers, breast cancer frequently spreads to bone and often appears as lytic lesions, making the statement that breast cancer commonly causes lytic lesions true. Dexa scans measure bone mineral density to diagnose osteoporosis and assess fracture risk; they are not the right test for evaluating focal lytic bone lesions from cancer. Therefore not indicated for this scenario. Lytic lesions can indeed indicate malignancy, so saying they never indicate cancer is incorrect. Osteoporosis causes generalized bone loss but not typically focal lytic lesions, so that statement is also not accurate.

Lytic bone lesions reflect destructive bone activity, often due to malignancy spreading to bone or to conditions like multiple myeloma. In an older patient with weight loss, new focal bone destruction is most concerning for metastatic cancer rather than benign bone loss. Among cancers, breast cancer frequently spreads to bone and often appears as lytic lesions, making the statement that breast cancer commonly causes lytic lesions true.

Dexa scans measure bone mineral density to diagnose osteoporosis and assess fracture risk; they are not the right test for evaluating focal lytic bone lesions from cancer. Therefore not indicated for this scenario. Lytic lesions can indeed indicate malignancy, so saying they never indicate cancer is incorrect. Osteoporosis causes generalized bone loss but not typically focal lytic lesions, so that statement is also not accurate.