Question about detecting mets when mammo didn't detect cancer

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My DIL has lymphoma. It began, apparently, in a lymph node in the groin area. That was taken out, she got radiation in the area and for follow-up she gets a complete body scan every year to see if the cancer has settled anywhere. So far so good!

I think this must be a PET scan? So if all of us who have had cancer could get one of these every year mets would be discovered. But probably insurance would not pay!

JMO!

My onc is planning yearly PET scans even if the tumor marker blood tests don't indicate a need. Personally I would like a scan twice a year after my cancer not showing up for years on regular imaging! If my onc had not agreed to yearly scans at least, I wold be looking for a new one!

Good Luck Ladies. Happy Thanksgiving!

Does a pet scan give off radiation?

Here is another issue with regular screening. You can have a perfectly clear scan and two months later develop the symptoms of mets. Cancer doesn't grow at a constant rate. Like its human hosts, it has growth bursts. I have personally known people it has happened to and have seen it many times here on BCO.

Good point Pip!

Roses - I have really dense breasts I guess, because my 9cm tumor didn't show up on a mammogram. The Ultrasound was able to detect it. Given that you are stage III, I am going to assume that you have or are going to have Chemo and since you're er+, that you'll be put on one of the AIs. These are both systemic treatments. I am also guessing that they did some type of full body scan prior to your surgery which showed no mets & you know that there could be micromets that don't show up. Bones and brain & liver are different than breasts so there's no reason to believe that just because your breast scan didn't show tumors, that they wouldn't show in other parts of your body. If you do have micro mets, then the systemic treatments are treating them.

Here's why they don't generally do scans: Let's say that somebody has bone mets but no symptoms from them, but they are found on a scan. They have a certain number of treatments available (let's say it's 3). None of those treatment will 'cure' the cancer - they might work for awhile to slow the progression, but eventually that cancer will find it's way around the treatment. Once it does find its way around the treatment, that treatment won't be effective. So if you find the bone mets 'early' and use one of those treatments, you take out one of the treatments in the arsenal of treatments to use - and would you really want to do that before there are any symptoms? All that would happen from doing scans is that you would start treatment earlier & have that treatment lose its effectiveness earlier. That's how I understand it anyway. But I also understand how tough it is to not know & worry.

Mets cells react differently, but it's not only that. Breast cancer that is confined to the breast does not kill you. The breast just isn't necessary for your survival, liver, bones, lungs, & brain are. The first line of defense when you find breast cancer that has metastasized to a distant location is surgery - get rid of those cancer cells before they go anywhere else in your body. Same with the nodes - if those cells are 'traveling' from the breast to the nodes, then they want to get rid of any nodes & usually zap with radiation to kill any that might be floating around.

Apparently this is not the case with met cells in bc. That is why you sometimes hear about someone with liver mets having part of their liver removed as tx in cases of other types of cancer. Breast cancer cells are more incidious. They scatter and seed and can remain dormant in many parts of the body for some time. Removing parts of an organ with BC. mets wil not have the same outcome. The nodes are the exception because they act as filters from the breast to the rest of the body and the hope is that none of the cells have escaped. As we know, sometimes this is what happens, but not always, which is why it is not a black and white issue.

Ziggypop, sorry but I would rather my oncologost find a liver mets that he can operate on vs one he can't, hence I would rather early detection. That operation could give me several more years on this good earth which is where I plan to stay for a good long time. Also, I would like to emphasise that there are many different kinds of breast cancer, some grow faster than others. You might well have a mets and not know it for a long time until it is diagnsosed due to pain or other problems which might appear unrelated. Proper treatment for better quality of life might depend on a proper diagnosis.

I do agree that ovedoing the scans can be a health concern so this is something to watch, but information is not our enemy, the cancer is. Having had my BS tell me recently not to worry too much about that stage/grade thing (he almost didn't tell me...), this is a hot button with me, However, it has left me wondering, do dr's think we can't handle information when we ask/want it and so they put up additional barriers to get it when it might not be good? Last I looked I was made of more than sugar and spice and everything nice - Yup, we ladies are smart and have backbones too.

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Roses, it took me a bit to get over the slow-mo shock of realizing that what all those fancy scanning devices can really detect is quite limited. It is a work in progress for me to come to terms with it, but I figure that if I feel well, have no symptoms and nothing can be detected, then I might as well carry on as if I am NED.

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I began mammograms at age 40 and they were all clear. Then at age 46, I found the cancer during my monthly self-exam. After the mastectomy I told a radiologist 'I don't trust mammograms, they never caught mine!" His response was that it might have been an error by whoever read it and they were only 85 percent correct, etc etc and thefore it would be stupid of me to quit having them. So I continued ---until at age 74 I once again found a cancer during my self-exam. All those years of mammograms; uncomfortable, expensive, giving off radiation and yet they missed a cancer AGAIN.

I have only had one mammogram since my lumpectomy in 2011 and am not in a hurry for another. I check my breasts every month though and as the breast center director told me "You need to do both, you can't rely on a mammogram alone." But I know women who trust mammograms completely and never do self-exam. One discovered cancers in both breasts, fairly large ones, and had a double mastectomy.