What is the use of PET Scan?

Wow! You sound like me with most medical issues...the conundrum patient. Basically what you’ve got going on is the scans seem to show something going on in those areas but pathology does not necessarily match it. The oncotype score is a test done on the actual cancer tissue removed during biopsy/lumpectomy/mastectomy and there is an algorithm they use to determine the score. It has nothing to do with lymph node involvement. Lymph node involvement would change the staging of the cancer. Both help determine treatment though.

So let’s look at the PET scan. PETs show “hot spots” or areas where there is a lot of glucose uptake. Some parts of our bodies naturally have higher glucose uptake like our brains. Others do not have as much, so when they light up as a hot spot on the PET, cancer is likely as cancer cells typically use a lot of glucose. However, we should also look at whether you were given pre-scan I structions on diet and activity and if you followed them to a T. If not, you’ll need to bring that up to your MO as it can cause false positives. Likewise, inflamed tissues can also cause hot spots as they are also using a lot of glucose.

Your MO hit the nail right on the head with stating they don’t normally see IMLNs unless many Axillary nodes and even supraclavicle nodes were positive. But unfortunately there are always exceptions to the rule, hence her stating “normally”. I’d see what you could find online regarding low oncotype score, positive IMLN nodes without positive Axillary and supraclavicle nodes and see what comes up. Hopefully your care team is doing the same. As of right now the choices are do nothing, keep the same course as before, or pull out the big guns and do chemo + rads.

Here’s a link to another thread on BCO with similar situation from 2009. According to it, the IMLNs can be removed. Perhaps the danger is in trying to just do a biopsy vs an excision (kind of like with liver nodules). I hate you’re in limbo with this. I hope this helps you out.

https://community.breastcancer.org/forum/96/topics/740162

My Oncotype score was also 3 and my report also showed a higher survival rate without chemo. My doctors could not figure out why I had micromets in 1 node with my little lazy tumor. I have wondered if the node was cleaning up residue from the biopsies (I had stero and needle the same day) and they took several samples from each. I wonder if that could be the case with you. Since your tumor was in the inner quadrant maybe the node closest picked up the biopsy/surgery loose tissue. I assume your Estrogen and Prog. were high since you are grade 1 so the hormone blockers should work very well. Best wishes!

Crystal_sola I wonder if they could radiate that area instead. As I understand it, radiation is very effective on nodes. I had 2 nodal areas radiated for extra protection although they were not in the IMLN area. This might be a better choice since your Oncotype score was so low and chemo might not be effective.