Lump in Neck turned out to be mets - Lymph Node and Liver

paloverde

Hi everyone,

I was on vacation 3 weeks ago with my family and discovered a suspicious lump on my neck, about 3 inches to the right of the midline and just above the collarbone. I had a routine appointment with my onco scheduled for 3 days after I got back - I had just graduated from the 4-month frequency to the 6-month frequency. Was pronounced NED in Sept 2014 after ACT chemo and 28 rad treatments.

A neck & chest CT scan was ordered, and I got the results back 2 days ago. Long story short, the lump on my neck is an enlarged lymph node, they saw some midline thoracic lymph nodes that looked questionable, AND a 5cm x 3cm mass in the liver along with "numerous" others (unsure of their size relative to the largest one). They will biopsy from the liver, not the neck - I will be going to radiology for that this morning, since it will be CT guided. In addition to the regular ER/PR and HER2- pathology tests, they will send out for a tumor genomic panel called FoundationOne.

Well, shit. To complete the information gathering, on Tuesday I will have an abdominal & pelvic CT scan and a full body bone scan, just like at Christmas 2013 when my pathology from the BMX and ALND showed 11 nodes positive out of 16 removed. Then the "strategy session" with the onco a week from today, pulling together all the test results and discussing a plan.

The good news: 1) my blood work from 2 days ago came back completely normal, including liver function; 2) I wasn't told of any lung masses showing up in the chest CT scan, they told me 2 weeks ago my lungs sounded clear, and I have no shortness of breath; 3) nothing leaped out of the neck & chest CT indicating obvious bone mets, and I don't have constipation or other symptoms you'd expect if I were dumping calcium from bone breakdown; 4) no headaches, tremors, trouble with coordination, weird cognitive symptoms (except the usual occasional chemo brain trouble grasping for the right word), or anything else that would signal brain mets; and 5) I feel generally okay except that my appetite is increased and the big lymph node is painful.

I'm continuing with my tamoxifen that I've been on for 2 years (I also had ooph 2 years ago) and my mood stabilizer for bipolar, same as I've been taking for over 10 years. My diet's not terrible but not fantastic - I just went back to Weight Watchers after a 6-month hiatus, need to lose 20-25 pounds. I get some exercise (walking) and thinking of going back to weight training as well. I had a bout of depression the first half of this year, largely situational, but it's been lifting over the last month.

Any comments about what I might expect in terms of treatment recommendations and future concerns? The original tumor, though not large, had been Grade 3 and 30% Ki-67. My BS told me some tumors are growers and some are spreaders, and I had a spreader. So between that and the extensive lymph node involvement, I was pretty sure I'd go stage IV at some point, but since in 2014 my onco estimated only a 15% chance of distant recurrence over lifetime, I thought I'd be in remission for 5 years, maybe 10, certainly longer than 2. I now think her number was too optimistic, though I have high confidence in her in general.

Thanks for listening. I'll update after Sept 1. A blessed day to all.

KBeee

I am so sorry you are dealing with this. I hope you have a plan in place soon. I have a local friend with liver mets who is doing oral chemo and is doing well so far.

ElaineTherese

Ugh! Well, at least it sounds like your doctors are being very thorough. Hope they come up with a plan that works for you! ((Hugs))