PET Scan vs. CT Scan

Hello, and thank you for taking the time to review my question.

When I was initially diagnosed with breast cancer (in April, 2008), one of the tests performed was a CT Scan (of thorax, chest, abdomen, and pelvis). The CT Scan showed *no* abnormalities.  

Q1. Can I take this as confirmation that there is absolutely *no* metastasis to the regions that were scanned? Or, should a PET Scan be performed?  

Q2. Regardless of insurance paying for scans, these days, which is the preferred post-chemo follow-up option to keep a close eye on my health: a PET Scan, or, CT Scan with Bone Scan?

Thank you.

[Cleveland Clinic]

Dear Krista40:  A negative CT scan means that there is no apparent disease that would be picked up by a CT scan.  In general, the assumption is that there is no metastasis.  Neither a CT scan nor a PET scan can identify microscopic disease so one can never “guarantee” that there are no cancer cells anywhere else.  In the setting of breast cancer, adjuvant chemotherapy is given to treat any cells that may be present and too small to detect.  PET scan has not been shown to be overwhelmingly helpful for staging beyond CT and bone scan.  Follow up should include regular mammograms and physical examinations.

[japdip]

Usually the Oncologist has a preference as to what scans are ordered after treatment. Some in fact do not routinely do any scans. There is no evidence of longer survival whether mets is found by scan or by the appearance of symptoms. Since the patient doesn't order their own tests; it's up to the Oncologist and their particular method of practice.