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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 44873
Experience:  Experienced Oncology Physician trained in New York City. I'm ready to help.
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I have Metastatic Breast Cancer diagnosed 4/2011 that moved

Customer Question

I have Metastatic Breast Cancer diagnosed 4/2011 that moved to the bone and 2 lymph nodes 3 months after TAC chemo 6 cycles, bilateral mastectomy with axillary disection of all 12 nodes positive for cancer, aggressive radiation including iso area. The spread was treated with 18 Abraxane infusions plus XGEVA shot. The lymph nodes resolved with treatment but we have been treating bone lesions every year. In April of this year I had 2 new lesions on left side where ribs meet spine and also traveled into ribs. In June there were 5 sterotactic treatments done to this area. Follow up scan in July showed increased activity in prior areas that had been stable so I was started back on XGEVA in August. Current Naf PET/CT showed decreased activity. However on the regular PET/CT it has been noted that I now have a new hypermetabolic right perihilar lung node or nodule SUV 8.2 there was also lower left lobe activity noted but reported stated it was likely related to the radiation done on ribs 5 and 6. My cancer is a a high PR and ER positive HER negative but has genetic mutations that are aggressive. I have been on 2.5 mg of Letrozole since December of 2012. I see my oncologist at Moffitt on Tuesday but she just took over in April as my previous oncologist who was very good went back into research. This will be my 3rd time seeing new oncologist and I am concerned about the PET scan results from Thursday.
Submitted: 1 year ago.
Category: Oncology
Expert:  Dr. David replied 1 year ago.

This is Dr. David

is the new Thursday PET scan the one which showed the SUV 8.2 in the right perihilar lung lymph node.

if it is easily accessible, your doctors may want to perform a bronchoscopy and biopsy of the lymph node to conform ER and her-2 receptor status of this new lesion in the lung lymph nodes.

some breast cancer cells can mutate and turn ER negative or Her-2/neu positive with time and this can alter therapy.

your medical oncologist might recommend second line anti-estrogen hormone therapy like faslodex injections which I don't think you have had

let me know if you have questions.

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