scans before vs after surgery

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Cheesequake
Cheesequake Member Posts: 264
edited April 2015 in Surgery - Before, During, and After

So my surgeon has indicated that some time after my lumpectomy and SNB - not sure when - they will schedule scans (PET, CT, etc). Is there a reason this is done after surgery instead of before? (I've sent an email to the surgeon, but thought I'd ask here as well.)

I know that the lymph nodes are the most likely first port of call for metastasis - how often does it metastasize to somewhere else first? Is there reason to push for scans ASAP? Especially if they intend to do them even if the lymph nodes are clear?

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  • Hopeful82014
    Hopeful82014 Member Posts: 3,480
    edited April 2015

    I had my scans as part of the diagnostic process, as I had a known malignant node.

    The only reason I can think to do scans after surgery would be IF any of your nodes were found to be involved, they would want to look for metastasis but it sounds as though the scans will happen regardless of your nodal status. Unless perhaps your surgery is coming up so quickly that there isn't time to get ins. authorization and schedule the scans? Or maybe it's just a matter of local preferences.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited April 2015

    Have you had an appointment with your oncologist yet?  Generally PET/CT falls under the purview of oncology because they are using this type of imaging to look for distant metastasis, not really anything in the breast.  I am thinking that the reason for looking after surgery is they would first like to know your nodal status, and they are looking due to your Her2+ tumor.  The aggressiveness of Her2+ cancer means they need an accurate assessment prior to chemo and targeted therapy.  Not everyone gets PET, either before surgery or after, for "early stage" cancer, but being Her2+ usually buys you that ticket.  If you are not having neoadjuvent chemo I wouldn't think it is necessary to do the PET/CT prior to surgery.

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  • Cheesequake
    Cheesequake Member Posts: 264
    edited April 2015

    I'm with Kaiser - all their authorizations happen internally and my surgery isn't until Apr 27, so I'm guessing this is just their standard procedure. My first meeting with an oncologist left me feeling very uncertain and I didn't like her, so I've scheduled to speak with a different MO two weeks after my surgery. We'll see what they say.

    Thanks for the responses!

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  • Nancy2581
    Nancy2581 Member Posts: 1,234
    edited April 2015

    I had a pet/ct and a bone scan after my lumpectomy. I had one positive node and then my MO ordered them.

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  • Hopeful82014
    Hopeful82014 Member Posts: 3,480
    edited April 2015

    SK - While it's true that many times scans are ordered by MO, all of mine have been ordered by my surgeon. I think there's a lot of variation on this issue.

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  • Kicks
    Kicks Member Posts: 4,131
    edited April 2015

    Our DXs are different (as are our Drs) and there are different protocols for the different types. Personally, I did CT, MRI, PET and bone scans before neoadjuvant A/C. The PET did 'light up' on a spot along my lower right jaw and the area was biopsied but 'nothing there'. Neither my Chemo Dr or my Surgeon felt there was any reason for any scans after neoadjuvant chemo, surgery (UMX) or adjuvant chemo but my Rads Dr insisted on a new CT before starting rads so had one the day of last Taxol as I was starting rads a week later.

    But we are all different and there is no 'One Size Fits All' when it comes to DX, TX or how our body reacts.

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