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Breast Cancer (Expert Forum)
Inflammatory Breast Cancer and differentiating liver met from hemangioma
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
Inflammatory Breast Cancer and differentiating liver met from hemangioma
by highaim, Mar 18, 2004 12:00AM
I have posted here before. In May '03 I was diagnosed Stage IIIb IBC. After 8 cycles of neoadjuvant chemo, bilateral mastectomy (11/11 axillary nodes showed fibrosis as evidence of necrotic cancer tissue), and 35 rads, I have developed severe and painful symptoms of gall stones. Onc wants to do 2 more cycles of chemo for good measure.
I had a UTS last week (ordered by surgeon), and a 1 cm lesion was viewed on one lobe of my liver. It is assumed by radiologist to be a cavernous hemangioma, as no other lesions are apparent. However, report remarks that the possibility of a liver met cannot be excluded.
How are hemangiomas caused, and why wouldn't this have been evident on my CT scan in 11/03?
Is it unreasonable to request another CT scan (last one was in 11/03) to be certain this isn't a liver met? And would it be standard practice for a physician to order a CT/MRI/PET scan after a finding such as this in a patient with a history such as mine?
Also- I had heard the gene for IBC had been isolated in the lab. Are you aware of a specific reference for this bit of research?
I had a UTS last week (ordered by surgeon), and a 1 cm lesion was viewed on one lobe of my liver. It is assumed by radiologist to be a cavernous hemangioma, as no other lesions are apparent. However, report remarks that the possibility of a liver met cannot be excluded.
How are hemangiomas caused, and why wouldn't this have been evident on my CT scan in 11/03?
Is it unreasonable to request another CT scan (last one was in 11/03) to be certain this isn't a liver met? And would it be standard practice for a physician to order a CT/MRI/PET scan after a finding such as this in a patient with a history such as mine?
Also- I had heard the gene for IBC had been isolated in the lab. Are you aware of a specific reference for this bit of research?
Doctor's Answer
by CCF-RN,MSN-rf, Mar 19, 2004 12:00AM
Dear highaim: Hemangiomas are benign entities. Other than that, we are not equipped to discuss their causes. However, the more important question is how certain are they that this is, in fact, a hemangioma. If there is any doubt, either by you or your doctor, given your history, it is not unreasonable to request a repeat CT scan. At this point, the research for the IBC gene is still very preliminary. One reference is Dr. Susan Love's web site http://susanlovemd.com/community/flashes/hotflash001120.htm
I will be having surgery to address the gall bladder problems, and I am wondering if I should advocate for a biopsy at that time? Or is that not necessary (I am also taking warfarin for a subclavian/jugular DVT caused by port, so I don't know the implications if it were a hemangioma)?