Pleural Effussion

I've been dealing with pericarditis, mild pericardial effusion, and radiation pneumonitis.

Did you have radiation as part of your bc treatment?

It may be wise to have a pulmonary function test. Did you get the chest x-ray? That's where I would start. Oxygen levels vary a little bit, so yours is completely normal. I've never heard that mastectomy would cause dull lung sound.

You mention the cough is in your throat. Could you have allergies or the beginning of a virus?

Hi Nikelady,

Like Cive, I also had exactly the same symptoms with a dry cough that would not go away and increasing shortness of breath with exertion. A chest x-ray showed fluid in my right lung. My general practitioner prescribed antibiotics while we waited for a CT scan but they had no effect. The antibiotics will only work if it is an infection like pneumonia.

I did not have low oxygen as only one lung was affected. The dullness is due to the fluid. Have you had the x-ray yet?

I hope you can get your physicians to check this completely.

No, PE is not considered mets. PE just means there is fluid in the lungs. The fluid could be due to a virus or a bacterial infection.

A CT shows much more detail than an X-ray, but it's more radiation exposure and more expensive. It's also not always necessary to jump right to a CT when an X-ray can show something like pneumonia or another infection.

If you're still concerned, then ask for a chest x-ray. It will put your mind at ease.

They can biopsy the fluid to see if mets are present. Hoping there's some other reason!

Nilelady, a pleural effusion can have many causes. One of those causes is mets but there are many others.

You could also have some kind of "pneumonitis" [lung inflammation] or pneumonia, but with those your lungs wouldn't sound clear. Chest x-ray can diagnose both of those.

Pneumonitis is treated with steroids as it's inflammatory and not infectious. Pneumonia is treated with antibiotics.

As I mentioned earlier, they did not find my bi-lateral pleural effusion until they did a CT scan.  Even when my Dr. sent me to emergency, they couldn't find it on Xray but he is well known enough that they believed him.  So they drained the fluid and tested it for various pathogens but also did a test for BC mets.  But there are many things that can cause a pleural effusion.

When they biopsy something, they send it to pathology. That can not only rule out mets, but if it is bacterial, it can guide treatment. There are many reasons for pleural effusions. I hope it is resolving. A broad spectrum antibiotic can also be used. If it resolves, that eliminates the need for the biopsy

Then it will probably just be absorbed by your body and you don't need to worry about it. I have some fluid around my heart that is also too small to aspirate, so we will just wait until my body absorbs it.

One of my doctors always says, "Bad things don't get better. They get worse." In other words, if your cough is gone now and if the fluid level is too low to aspirate, then it sounds like things are getting better and you can relax a little about it.

Now, if your symptoms continue, or if a repeat imaging shows more fluid, then you may have to look into it more. But for now it sounds like things are going in the right direction, which is great news!

are you on Tamoxifen? With it hurting to breathe it could be pulmonary embolism that has caused pleural effusion. It is an established SE of Tamoxifen. CT required to make diagnosis. I just went through this. Leg hurt for a few days which I chalked up to surgery from a couple years ago. Then hurt to take a deep breath. Went to ER, and scans showed bilateral blood clots in lungs and pleural effusion. If it's hard to breathe or hurts to breathe, get thee to the ER post haste. Hope things continue to improve!

NileLady: I have copied what you said on the 2nd thread you started - posted 6/20, just 5 days ago. So it sounds like pneumonia is a big part of the problem. I do hope you are continuing antibiotics and getting a lot of rest. And a lot of water. Pneumonia can be very serious. It takes a long time to recover.

In june 2017 i was diagnosed with pneumonia and given antibiotic injections. I had this shortness of breath that improved after treatment butnit fully gone.

My dr insists it is pneumonia while i saw another one who wants me to repeat the x ray suspecting it is plural effussion belieing it can be cancer

My oxygen is good no fever slight cough from time to time active but i still feel i am not 100% fine. My blood work is good

No - I do not research much on the internet except a few trusted sites. Lots of junk out there that is badly off base. I trust my docs.

Go back to the doc that said pneumonia and ask him if it's cleared up. If he can't hear anything in your lungs, tell him about your shortness of breath & ask him about pleural effusion. He'll probably tell you just what we did - stay off Google. But if there is still something there, you need more antibiotics & maybe another X-ray.

AND YOU NEED TO REST AND DRINK LOTS & LOTS OF WATER. Pneumonia won't heal itself. And sometimes takes a month or more to clear up.

Nilelady, If you had a pleural effusion of any size your oxygen saturation would not be normal.  Another thing that can make you short of breath is related to the heart and is especially bad when you are anxious.  More than that I can not say what your problem is. 

NileLady - If I remember from your previous posts - you had one doc that said pleural effusion and one doc that said you do NOT. Maybe the treatment for pneumonia didn't last long enough? I hesitate to recommend more "doctor hopping", but maybe going back to a good internist who hopefully get to the bottom of your cough. It may be totally unrelated - some way out thing like Lyme disease. Since you didn't post your diagnoses & treatments in My Profile I have no idea about previous breast cancer, but I do hear that you are scared.