Change in Lung Nodule - Yikes?!?!

TeddyM

In March, I was seen for a sharp pain in my chest and two 6 mm nodules were found on my right lung and one 6 mm nodule on my left lung.  The doctor said I had atypical chest pain but said that in view of my breast cancer history, I needed to follow up with my oncologist.  He initially said that he didn't know what to make of it.  In April, I had a normal chest x-ray and tumor marker blood test. Last month, I had a second CT scan and while the nodules in the right lung had not changed, the one in the left lung had grown to 11 mm.  My blood test was normal again.  My surgeon and oncologist want to wait 2-3 months and repeat the CT scan.  They aren't sure a biopsy would be successful as the nodule is still small.  My liver has not changed since a CT scan in May 04 and my bone scan in Oct. 09 was normal.

 Has anyone had a nodule caused by radiation?  I had 30 treatments (finished May 2010).  I have wondered if the chest pain I had in March might have been a respiratory infection that caused some inflammation that showed up.  I breezed through my lumpectomy, chemo, and radiation and am doing well with Arimidex/Anastrozole.  My oncologist is going to switch me to Aromasin though (not sure why).  He said that he was sorry to have to put me through all this . . . especially if it turns out be nothing.  I feel absolutely GREAT but am sick with worry about the growing nodule.  It seems that nodules are caused by a ton of things, but the ones that grow are cancerous.

 Thanks in advance for any input, explanations, ideas you can offer! 

pennylane

So sorry you have to go thru this Teddy...I have been there re lung nodules so always try to convey my experience to those having to deal with facing their mortality yet again...I was told I had diffuse sub-centimeter bi-lateral lung nodules just a few months after treatment (chemo, rads)...That was over 5-years ago so have read up quite a bit on these things.Yes, you don't want changes, but you know, 11mm is very tiny, like half a dime...does your onc really think this is significant growth?I mean it was just a spec when they found it so maybe it was not ready to settle down yet..As for rads causing lung scarring..yes it absolutley does...so many of the women I met going thru this scare thought it was the result of rad treatment...which by the way, caused me great pain in my ribs, weight loss, and a nasty cough....I know it was truly a walk in the park compared to chemo, but it does take a toll on the body.  Lungs get nasty scars very easily from many different sources....Perhaps you had pneumonia in the past, or even any recent congestion can be enough to cause unusual scans.   I never had a lung biopsy by the way, just 2-years of scans and evaluations...You quickly get good at living between scans...You will see Teddy....You are early stage and chances are so very good that this is nothing...Hang in and stay in touch here, Best wishes,P

reesie

I haven't experienced anything like this but my thoughts are that "if" you had mets and had progression it would be standard to change the ai then to see if there was any response after a couple of months (any change bigger or smaller would then indicate mets). It might be part of his approach - he's not just doing wait and see, he's being pro-active.



Hopefully the difference shown in the CT wasn't growth but whatever caused the nodule was "in process" the first time and what appears to be growth was just a timing fluke.



Sounds like your onc is on the ball though. Good luck.

TeddyM

Thanks penny lane and reesie . . .Both my oncologist and surgeon have raised the possibility of the nodule being many things, but the concern is the change in the left nodule in 3 months. I did have a sharp pain in my chest in March (that's how they found the nodules in the first place) and I've always wondered if it might have had some connection. I did have pneumonia 6 years ago and am hoping that caused the nodules that did not change on the right.



It's too small to biopsy, too small to cause symptoms, and too small to call it anything but "indeterminate" . . . But it is too big to not cause huge concern.



As for the change from Anastrozole to aromasin, both doctors didn't put much urgency into the change. They said I could finish the Anastrozole before starting the other and all they really said about the change was that aromasin has slightly different properties.



Again thanks for your input. I appreciate it.

3monstmama

many <<hugs>> from another woman with a funky lung nodule.  Mine was discovered during all my BC testing.  Eventually it was determined to be nothing of significance well except that they do a CT scan on me every now and then.  Honestly, I try not to think about it.  One of the things I was told is that your body will often grow strange little things inside that are really nothing.  Me, I've got strange little things in my left lung and in my liver and in my thyroid.  They aren't significant, they are just me.

I would be suspecious of the respiratory infection.  I know that post zaps---when I was diagnoised with radiation pneumonitis-- my stupidnodule was a bit bigger.  hang in there!!!!!

pj12

I am another one who had a lung nodule show up in my initial BC work up. I wish they had not found it! I am now 2+ years post DX and have had three lung CAT scans and one PET scan. All inconclusive. I was supposed to go back for another CAT scan in June but am dragging my feet. I think I will do it in October. I am now more afraid of the radiation than I am of the nodule I am hopeful that if it has not changed after this longer interval the doctors will be comfortable ignoring it. 

There are just so many benign possibilities and I am hoping that is the case for both of us. Good luck. 

TeddyM

Thanks mama and pj . . . the most concerning thing is the growth . . . 5mm in 3 months.  I don't know how significant that is and hope that the two scans aren't telling the whole story and that it was just caught at its smallest and largest point.  I also don't really know what "indeterminate" means, other than nothing can really be ruled out.  

I don't know if a scar from radiation or inflammation/infection can change in size or if it can appear as a roundish nodule on the CT scan.  I am glad that the two nodules on my right lung did not change and that I have no spots on my liver.  The waiting and wondering is definitely the hard part!  I try not to think too much about it either, but those little "what ifs" always seem to creep back into your consciousness.

cp418

I would also consider a pulmonary specialist for consultation especially since you previously had a respiratory infection.  Sometimes 'stuff'' is left behind after some infections..........

bevin

Hi teddyM, another similar experience here.  I also have a lung lesion on my pleura. Its 3cmX6cm, so fairly large.  I have had 2 CT scans and a PET scan.  If I could suggest, I would ask for a PET/CT combined exam the next time. My PET uptake was 3.7 so showed uptake but not so high they felt they needed to biopsy.  I am waiting another scan and they did refer me to a pulmonary specialist to help with decisions, review and diagnosis.  I know its scary to not know what something is. I definately empathise with you.

Though, I will say, watching with scans seems to be the norm and I know at least for me, they are not so excited by what they see that they want to go in an biopsy.  It makes me more comfortable knowing that.

So, please if you can, see a pulmonary doctor and also ask for a combined PET/CT they are much better at diagnosing lung mets than a CT alone according to research I read.  If I cna figure out how to link it for you, I will post the research on this. If I recall, it was 98% accurate in diagnosing as compared to a CT alone.

TeddyM

cp . . . I don't know if a respiratory infection caused my chest pain.  Something did, but I don't know what it was.  I guess I'm just hoping it might be related.

bevin . . . I will be scheduled for a CT scan in Aug/Sept.  I'll see what they say about a PET.  My nodule is apparently somewhere in the upper left lung (same side as my lumpectomy and radiation).

It's sure hard to sift through information.  Most leads to lung cancer sites.

Thanks again for everyone's help! 

  

REKoz

Another here with lung nodules found prior to chemo. I just had another 6 mo. PET/MRI showing no change. This seems to be a common situation in general I think.  We bc gals just know about them from the scanning we have had done. Maybe we should start a "who has lung nodules thread!"

I too would be a tad freaked by a change at this point. I feel for you Teddy and am sending many positive thoughts your way.

pj12

Just bumping this thread to see how everyone is doing. I go for another PET scan tomorrow so all,of this is on my mind again. It is easier to ignore it!