Hilar Lymph Node on PET Scan

[WorriedSon1111]

Hello.

My mom was diagnosed with breast cancer in her right breast about a month ago. Before going for the mastectomy, she had a PET scan which showed normal activity in the brain, adrenal glands, bones and lungs.

However, there was is one thing that the PET/CT showed which is making me worry a lot and which the doctors are not emphasizing much.
She had the mastectomy done two weeks ago (Tumor size: 4cm, 1 out of 10 lymph nodes in the axilla (5mm), ER+++, PR+++, HER2/Neu -).

The statement says "There is left (other side) hilar lymph node measuring 7mm showing increased tracer uptake SUVmax = 3.59 which showed mild increase in activity on delayed image SUVmax and is likely reactive in nature".

My question is, would that be suspicious of distant metastasis. All the doctors I have spoken to didn't support a biopsy because this could be due to a wide range of inflammations (she is a smoker too), and one doctor said that this is not the typical route of metastasis of breast cancer.  Her CA 15-3 and Alkaline phosphate levels are all within normal ranges.

Would appreciate it if you can let me know what you think. Thanks!!!
Worried Son

[japdip]

This post has been answered via Private Message .......

[WorriedSon1111]

Thanks a lot for your response. My question is that if this lymph node is positive, would it automatically move her from stage 2B to stage 4? Would her treatment move from curative intent to life prolonging? If chemo eliminates it and subsequent PETs are clear, does that mean she might be cured or it is only a matter of time before it reappears?

Also do you think that this is likely malignant or reactive as per the report. One of the doctors argued that it is not the typical route of metastasis of breast cancer specifically that the PET doesn't show anything in the lungs or other organs. Do you agree with that?

Thanks a lot! Worried Son

[japdip]

You are receiving accurate information regarding this lymph node. I do believe that it would be a good idea to keep this node on "watch" so to speak. With some lymph involvement I would think that Chemo may well be a part of her treatment plan and this might have some effect on this hilar node. It is true that there are so many reasons for a node to become enlarged and often after the cause is eliminated the node does not return to it's normal size. I'm sure the Dr.s are aware of this lone node and will be checking from time to time for any changes that might occur.   Regards ...