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Skeletal scintigraphy is claimed to be a sensitive method of detecting bone metastases, particularly since the introduction of the Technetium-99M radionuclides linked to bone-seeking diphosphonate compounds, such as methylene diphosphonic acid (MDP) (Bull et al, 1977a). Quantitative estimation of the uptake of these compounds has been advocated as a means of assessing the progress of bone metastases and of their response to treatment (Bull et al, 1977b). It requires the use of a gamma camera attached to a computer system.

The skeleton is the commonest site of distant metastatic disease in breast cancer. Conventional methods such as radiography are relatively insensitive in picking up these lesions. In recent years the introduction of new isotopes such as Technetium — 99m Methylene Disphosphosphonate (99Tc MDP) has made high quality bone scans available, but their role in the detection and further management of bone deposits requires to be established.

The growth tempo of tumours has, until recently, received little attention in relation to the clinical management of cancer, yet, when it can be recognised (as in the case of inflammatory cancer), the dynamic biological characterisation of a tumour may provide a much better clue to its clinical behaviour than does its histopathological picture. Even now, information on the growth rate and kinetics of tumours is scanty and based on studies of a small number of tumours. This chapter will examine clinical behaviour of rapidly growing malignant tumours in relation to underlying biological phenomena, under the following headings: Inflammatory cancer and other rapidly growing tumours Clinical demonstration of rapid growth Relationship of rapid growth to biological indices Changes in tumour growth rate Relationship of rapid growth to immune deficiency states Prospects for clinical detection of rapidly growing tumours