allicat1214 Posted January 22 Share Posted January 22 Hello, I am a breast cancer survivor. I had a 1.5 cm tumor in my left breast, diagnosed 12/14. Had lumpectomy, 4 rounds of chemo (taxotere-cytoxan) and 33 rounds of radiation, all completed by 9/2015. August of 2023 I had an MRI for a gastro issue, which showed a nodule on my right lung. Had an immediate CT scan w/contrast. That report stated a single 6 x 8 mm solid lobulated nodule in lower lung. Follow up in 6-12 months. I had read that lower nodules were not as high risk so I wasn't too concerned but had planned to ask my oncologist. I see my oncologist annually to follow up with breast cancer in the Dec/Jan timeframe. Early in January, I asked my oncologist via my message portal about doing a follow CT scan before my appointment. She ordered it without contrast. THAT report said: Stable indeterminate right upper lobe nodules. No new or enlarging nodules. Attention on follow-up. It further stated Unchanged right upper lobe solid pulmonary nodule measuring 6 x 8 mm (3; 227). Unchanged additional micronodules within the right lung apex (3; 68 and right upper lung (3; 171). So I'm glad that it's unchanged... I know that is GREAT news. But have you ever seen two separate CT scan reports identify the location in two different places? And one report said a single nodule, while the other indicated multiple??? I'm trying to understand that. But the second one said "unchanged" as if it's ALWAYS been in the upper lobe. I also had a mammogram that showed NED. My breast cancer was diagnosed and treated at a medical facility in the New Orleans metro area. I never had a CT scan, much less a full body scan to determine if cancer spread. Only mammograms. I have read through several PubMed papers and risk analysis on the Society of Thoracic Surgeon webpage and understand that a lobe in the upper region has more risk, and it seems as if 8mm size is sort of the cut off for further actions, like biopsy. I have now moved to the Atlanta metro area and see doctors at the Winship Cancer Center at Emory, an NCI Comprehensive Cancer Center. They seem to have a great reputation so I am hopeful for better care here than in Louisiana. I have had a number of health issues since I've been a teenager, so I am very used to advocating for myself. I want to know if this might be a breast cancer that has metastasized to the lung or a primary lung cancer. From what I've read, there is a vast difference in treatment and outlooks for these very different cancers. What would you recommend I ask the doctors to do? I'm uneasy with just a wait and see approach in the upper lung....after going through all the treatment I went through for breast cancer. Thanks for any suggestions. I know you cannot give out medical advice, but what you went through and how you advocated for yourself would be helpful. LouT 1 Quote Link to comment Share on other sites More sharing options...
Sallysh Posted January 23 Share Posted January 23 I would ask for a biopsy. I also had breast cancer many years ago and then was diagnosed with lung last year. A biopsy will tell whether it is from the breast or a new cancer. That’s very important to treatment decisions and outcomes. Sound like you’re in a better location for good treatment. Good luck LouT and allicat1214 2 Quote Link to comment Share on other sites More sharing options...
LouT Posted January 23 Share Posted January 23 It may not be so uncommon that separate scans produce some differing images. It’s good to hear that the nodules are not growing or presently considered malignant. Having said that there may be other tests they can run. For example, a PET Scan could show up malignancy in cells within the nodules or not show anything (good news). But at the end of the day a biopsy is considered the gold standard for determining the malignancy or non-malignancy of a growth. Sixty percent of nodules are benign but as a former cancer patient (like me; colon 2010, lung 2019) I would always error on the side of more data and confirmed testing. Lou Tom Galli and allicat1214 2 Quote Link to comment Share on other sites More sharing options...
allicat1214 Posted January 23 Author Share Posted January 23 Thank you both! My oncologist today said she didn't believe the nodule was as a result of my breast cancer, which was stage 1 and now 9 years ago. She said it was positive thing that there was no growth from August 23 to January 12, 4.5 months. She referred me to a pulmonologist within Emory to manage the nodule and the first available appointment is late April, so another 3 months. The doctor I'm seeing is young, but has good reviews.... so I'm hopeful! I'm satisfied with that for now because it isn't growing.... or at least it isn't growing at a rate that would be detected within 4.5 months. Lou, Thanks for the suggestion about the PET scan. I'll make a note to ask that when I see the doctor. But I agree with both you and Sally, that a biopsy is the best way to know what's what. Again, I thank you both for your suggestions. Quote Link to comment Share on other sites More sharing options...
tgif i guess Posted January 24 Share Posted January 24 i love pet scans i had a ct scan - it had a note from the radiologist that recommended a pet scan - my gp did not order the test - when i kept getting worse, my gp reluctantly granted my request to see an ent - he ordered the pet scan i think the reluctance is the cost and if your insurance will cover it (without a cancer diagnosis) - my insurer did approve it and the images showed all the lymph nodes in my chest were involved a ct has its place and you can look at the images and understand them - a pet scan makes no sense unless you know how to set all the contrast settings in the pacs system - then you see the cancer in color - amazing technology (and the test itself is easier than mris) they test your glucose level, shoot you up with a mildly radioactive glucose solution, recline you with a warm blanket for about a half hour - then put you on the scanner with a wonderful pillow under your knees - 20 minutes later you are done my second favorite (and underrated test) is the cea blood test radiologists prefer that tests are performed on the same scanner interestingly (for a nerd like me), a pet scaner can do ct scans also TJM, LouT and allicat1214 3 Quote Link to comment Share on other sites More sharing options...
edivebuddy Posted February 2 Share Posted February 2 Not a doctor but before you worry needlessly, over 80% of solid pulmanary lesions are benign. But just in case You should ask for a PET/ CT scan as recommended by the NCCN guidelines for solid lesions >8mm. You need to register to see anything but it's free. https://www.nccn.org This is the RADS that will tell what's suspicious. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Lung-Rads While a PET is not perfect it's way safer and less painful than a biopsy. If nothing glows you can probably skip the biopsied If the PET comes back not suspicious then LDCT in 3 months if no charge 6 months then yearly LDCTs until you're longer a candidate for definitive treatment Don't settle for less than the guidelines. LouT and allicat1214 2 Quote Link to comment Share on other sites More sharing options...
Karen_L Posted February 4 Share Posted February 4 Welcome aboard, @allicat1214. Sorry you need to be here, but it's a great place to land. I'm glad to hear how confident you are about your ability to advocate for yourself. I'll join in on the chorus supporting a biopsy down the road. Tissue biopsy is considered the gold standard, although liquid (blood) biopsies are often a place docs start if they want a relatively faster result (days instead of weeks.) Totally agree with the value of the NCCN site. Good luck, and keep us posted. Tom Galli and LouT 2 Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.