muga says 25 echo says 65!

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jackboo09
jackboo09 Member Posts: 920
edited June 2014 in HER2+ (Positive) Breast Cancer

Hi everyone

What an interesting day ive had. Went for Herceptin tx 13 today. Latest muga was 25 (a huge drop from 50) As a result tx didnt have the treatment and was whisked off for an emergency ECG  and ECHO. 

For extra dramatic effect I was transported to cardio dept in a wheelchair, feeling 95, not 41.

The technician who did my echo wasnt supposed to tell me my results but he sensed how anxious I was. His scan involved 2 different methods and both came out at 65!

Went back to see onco who looked somewhat bemuzed. The ecg was also normal, as was my blood pressure. he couldn't understand the 2 conflicting results and was getting a cardiologist to look at the scans. Herceptin 13 now postponed another week.

Has anyone experienced this anomaly? Surely at a level of 25 I would be experiencing worrying symptoms?

Your thoughts would be appreciated.

Liz 

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  • anna4969
    anna4969 Member Posts: 86
    edited January 2012

    jackboo,

    Wow!!!  That is a significant difference.  I experienced somewhat a similiar experience, but NOT with the big discrepancy you had!!  My muga came back at 50, which was a 17point drop from 3 months before and that did not make a bit of sense to me.  So onc ordered an echo a day later and it came back 74.  So, What was that about?  Anyway, what I did mention to the onc was that during the muga the technician bumped the table and I felt it as I layed there very still.  It was at the beginning of the first scan.  Personally, I think the calibration the machine needs to complete for one's body, might have been thrown off because of her hitting the table.  My oncologist wondered about that too, thus the order of the echo.  May something similar have happened during your Muga?  In any event, I don't think a delay of a week or several is anything to worry about at all.  Many women on this board have reported holding of the Herceptin and it didn't seem to affect any outcome. 

    Be Well :)

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  • Granuaile
    Granuaile Member Posts: 113
    edited January 2012

    My onc told me there's always a discrepancy between MUGA & echo. But not that much!! Hope all's well-

    Kate 

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  • jackboo09
    jackboo09 Member Posts: 920
    edited January 2012

    Hi anna and granuaile

    Thanks for your responses. I have a follow up appointment on fri 20th Jan. Im hoping I will get some answers. These scans are supposed to guide our doctors to make important decisions about our treatment. Have felt frustrated all weekend that supposedly reliable scans are throwing out such wacky results!

    Best wishes

    Liz

    P.S Surely at a muga of 25 I would hardly be able to walk!!!!!

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  • anna4969
    anna4969 Member Posts: 86
    edited January 2012

    jackboo

    Yes, please let us know after the 20th what the mishap was.  I am really thinking too that you would be walking to the bathroom and back is all, with the ejection fraction the muga gave you.  I can't imagine that you wouldn't be out of breath with the simpliest of tasks.  What is it like for you when you walk a simple flight of stairs?  Are you noticing anything?  If you have not a symptom, I very much wonder if it isn't a problem with the machine, or in my case an operator error by bumping the table.  I know when my echo was done the next day, the tech, though not supposed to comment, but he knew I was upset as a decent ejection fraction was needed to participate in a clinical trial that I was flying to 100s of miles away in 4 days, said everything looked beautiful and the echo was very detailed as he went up under my armpit and back to get a good image.  So, echos are quite reliable.  And you said you had two scans....so, yep, I have to think something was wrong with that muga machine.

    Do update us as soon as you can. :) 

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  • jackboo09
    jackboo09 Member Posts: 920
    edited January 2012

    Hi anna

    Thanks for your reply. I am now in the waiting game until Fri but I will be calling my onco wed so will update when I have more info. A bit more detail in the meantime.

    I have now had 12 Herceptin tx. During that time I have had some shortness of breath and palpitations. As a precaution I am on 2.5 mg Ramipril meds to help my heart. My onco believes that anxiety could be a factor but whilst that could be true I also think there is a heart issue (whether its Herceptin related, not sure) I do breathe a little heavily when climbing stairs but can walk briskly for an hour and feel great!!!!

    My previous muga results are: Baseline- 53, 47 (started Ramipril), 50, 25!

    Interesting comments about your experience. My echo technician also took pity on me as to be honest I was in shock having been told of the 25 result. He said scan looked great.

    My cousin experienced heart problems following avastin tx. She is TN. She ended up in hospital with breathing difficulties and blue lips. Her EF was 35 ish so if mine is 25 then Im sure I would be really struggling in a similar manner.

    Thanks again for replying. Will continue to update.

    Liz

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  • jackboo09
    jackboo09 Member Posts: 920
    edited January 2012

    Update:

    Had my 13th Herceptin tx on Fri.My onco had passed my scan info to a cardiologist and taking everything into account, he was happy to continue. 

    The muga which gave a result of 25 was looked at again. Apparantley, the muga is a 3D image and the techs believe there couldve been some overlapping issues which gave the low score. Sorry I cant be more specific. Somewhat flimsy explanation really. Cardiologists seem to favour echo as it shows the heart in action and all appeared well. 

    My onco is keeping me on a low dose ramipril which Im happy about as a kind of help for my heart during this treatment. I am walking 2-3 miles everyday and feeling great. Also going back to work (teacher)- when I can get a job, that is!!

    Many thanks to you all.I am sure it wont be long before something else crops up that I will want to share.

    Liz x

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  • Kay_G
    Kay_G Member Posts: 3,345
    edited January 2012

    The cancer center I go to only uses echos for chemo patients, no Mugas. They used to use them, but have switched because they think Mugas are unreliable. I am pretty sure you would have severe symptoms if you were really at 25. I think that's just an error. My echo went from 65 per chemo to 45 after 9 herceptin txs. I'm on a beta blocker and ace inhibitor to help my heart. I don't have any symptoms, but my cardiologist says most people don't at 45. I had adriamycin in addition to herceptin. There are several of us with the lowered ejection fractions on the herceptin heart attack thread on this forum. Check it out if you're interested.

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