Lung Mets on PET Scan/ To Biopsy or Not

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hikerchic
hikerchic Member Posts: 48
edited February 2017 in Stage IV/Metastatic Breast Cancer ONLY

This journey keeps getting tougher and more confusing, and I'm so exhausted I don't feel ready to make a decision so thought maybe someone here could share their experience.

I was unable to have staging early in my course due to pregnancy. After delivery and lumpectomy/node dissection, I had a clear bone scan and a neck, chest, abd and pelvis CT. There was note of one 1 cm lung nodule as well as a liver nodule. MRI of the liver failed to show any abnormality. My MO was not overly concerned with the lung as everyone has nodules and there was only one. I also have a history of recurrent bronchitis and pneumonia as a child.

I then went for radiation. My RO also was not overly concerned with the lung nodule. However, she did want me to see the MO for further opinion regarding antihormonals, etc., as there was no pathologic response and it is very aggressive Grade 3. I met with the MO and it was uncomfortable from the beginning. He didn't like questions and I always have plenty. He was concerned about the lung and ordered a PET scan. I had it and it showed the lung nodule as being suspicious along with a subpectoral node. He did say it was not "flaming hot" like usual mets, but showed greater uptake than surrounding lung tissue. Now he wants to do biopsy, but I am unsure of doing this. My regular MO wanted to go ahead with Ibrance and Femara and then rescan in three months. I told the second MO I would get back to him about my decision. I'm seriously so tired and burnt from 30 rads that I can't stand the thought of being poked and prodded again anytime soon.

Any insight into this or your own experience would be greatly appreciated.

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited January 2017

    I had lung 'artifacts' on two of my PET/CT scans. My MO didn't seem to be too concerned & recommended in both cases to wait & re-scan in 6 months. That said, we are all different and none of us are docs. Since you weren't particularly enamored with the MO & he didn't seem open to questions, I'd suggest getting a second opinion with another MO.

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  • Bright55
    Bright55 Member Posts: 176
    edited January 2017

    hi yes you do need a break

    recently i had CT scan and lung nodule biopsy easy as day patient .no problems .yes it was lung mets.and am same as you and now on leterzole my nodules are shrinking!so all good

    For you at this time all the biopsy would show if it was Mets or not and ID the the hormone and her status .

    you are already on leterzole so speak again to Dr to ask for biopsy mabe next month so as to give yourself a break .

    All the best



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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited January 2017

    Ugh. I remember rads. I didn't wear a bra for two months!

    It sounds like you have two options: that proposed by your regular MO, who wants to go ahead with Ibrance and Femara and then rescan in three months, and that of second MO, who wants to biopsy.

    Personally, I would want to know whether I had mets or not. So, I would go with the biopsy. But, you may find out either way. Presumably, if the Ibrance and Femara lead to the nodule's disappearance, then it may be presumed to have been mets. The only advantage to the biopsy might be that the MO can discover the nodule's characteristics, if it is indeed cancer. Sometimes, the ER/PR/HER aspects change (even if the nodule is an offshoot of your original BC), and you might want to know that for planning treatment.

    Sigh. Yes, you deserve a break. Best wishes!

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  • sharethehope
    sharethehope Member Posts: 115
    edited January 2017

    hikerchic

    I had a bunch of nodules in my broc tubes & had a biopsy it was neg actually something from the result of the chemo I was on. Also had a D&C & biopsy because of a thickening of uterus made onc suspect cancer. Just "old age" thickening.  Sometimes I think onc just want to protect themselves.. If your comfortable waiting a couple of months. Wait. If there were clear danger obviously you'd go ahead. Sometimes onc make me so mad I could spit. Both times I thought I had cancer.  Had one onc tell me I had a bone mound & because of my history it was probably cancer. Really - had this mess of bones for years & other onc had never been concerned. She really poured it on though. When my reg onc returned from sick leave he just tried to brush the whole bone mound thing away. She was a bitch & I'm not sorry for my French. April

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  • cive
    cive Member Posts: 709
    edited January 2017

    I'd go with your first MO recommendation and just rescan in three months to see if there has been a change.  The Femara you are on would be first line treatment even if you did have a lung met, and it well may not be a met.  Waiting 3 months won't change the outcome and they can see if it is actually changing or not.

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  • hikerchic
    hikerchic Member Posts: 48
    edited February 2017

    Thanks for the input! I'm going the conservative route (intuition is usually right). So tomorrow I go in to have my ovaries and tubes removed aND them start Femara next week. Two weeks after that I will start Ibrance. I'm hoping to just do 3 months of it, but repeat scans will decide that.

    I do appreciate all the feedback and listening ears when I need to vent. Sometimes I feel so alone in this journey.

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  • Heidihill
    Heidihill Member Posts: 5,476
    edited February 2017

    ThumbsUp You're on the right track! Speedy healing to you and lots of luck on Femara/Ibrance.

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