I have lobular breast cancer--had lumpectomy with poor margins/8 nodes positive (removed). ALLRED score of 8 and Her2 negative. So I am very estrogen positive. I am undergoing chemo, and will then do mastectomy, radiation and aromatase inhibiitors. I am 58 years old.

I had a PET/CT scan after they discovered the positive nodes. The ct part of the scan showed diffuse sclerosis almost everywhere, but no enhancement.  The oncologists immediately thought that it could not be cancer, because it was too symmetrical and even.   Since then I have had 2 negative bone scans, an MRI that showed no enhancement, and 4 bone biopsies from the place that looked worst (the top of the pelvis--iliac crest)--all four negative.

I ended up going to a bone specialist, and he did a bone scan, and found that I have the densest bones in the world. I am way out beyond the 99th percentile.

So, they decided that the salt and pepper look on the ct scan was from fluorosis, or some congenital bone condition. My oncologist pronounced me with no bone cancer. (I also had a number of blood tests that showed normal bone turnover).

But, I have become worried that we are missing the trees for the forest. In other words, I have this bone condition which makes the ct scan and the mri look dotted and dark. The only thing to go on is the lack of enhancement on both. I am worried that I have this dense bone condition, but on TOP OF THAT, I MIGHT HAVE A SMALL BONE METASTASIS. My doctor thinks I am wrong. I am afraid that the bone condition is HIDING the mets.

So, I have a three part question:

1. BONE SCAN: I know that it shows enhancement when there is bone turnover. But, I am worried that since I have lobular cancer (which divides slowly) and since I have this dense bone condition (which must cause low turnover) that any osteoblastic bone cancers might be hidden by this.
Do you think this is likely?

2. MRI: The mri of my pelvis and spine showed a darkened and stippled pelvis and I think spine. That is from the dense bone condition. BUT, if there were an osteoblastic cancer on top of this, would it have shown up? What would it have looked like against that darkened background? (It showed no enhancement, but I know you can't always trust that an mri will show enhancement).

3. CT/PET Scan.: The whole thing looked like salt and pepper. Again, due to the dense bone condition (fluorosis, or whatever). If there were an osteoblastic cancer on top of that, what would it have looked like? Or would it have just blended it? The other question is: I know that lobular cancer does not light up well on PET Scans because of the way if metabolizes glucose. Can I trust the "no enhancement"--or would that have been missed because it is lobular cancer?

Thank you.  I hope you can reassure me that these scans can be correct, and that my dense bones do not hide cancer in each of the above 3 modalities.