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Pet Scan accuracy in breast cancer

Pet Scan accuracy in breast cancer

I recently was diagnosed with invasive ductal carcinoma of the left breast. I had a 3cm lesion with a 6mm satellite lesion at the 8:00 location. I am 44 yrs old with no family history, no risk factors, and a negative mammogram July 07.  My genetic testing was negative. Last week I had a bilateral mastectomy (rt side prophylatic). My sentinal node biopsy was negative. My bone scan and chest/abd/pelvis ct scan were negative for mets. I work with Radiologists (I am an Ultrasonographer) who as a courtesy to me did a PET/CT. They feel they see some involvement in some subclavian lymph nodes which would put me into stage III.  My breast surgeon was reluctent to use this information. This is such a new modality to him he didn't feel confident in its results.  I heard that Pet/CT scans have been known to report false positive results regarding breast cancer. I have also been told that the images are so detailed that more information is seen earlier than our medical community is familiar with.  I worry that not addressing this issue will harm me with a recurrence later. What do you know about PET/CT and suggest I do?  
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242527_tn?1292452740
Dear puntacana:  The role of PET scan has not been well established in breast cancer.  A PET scan is designed to identify areas of hypermetabolic activity (as many cancers are), thereby, presumably, identifying early disease early.  It is also possible to have hypermetabolic activity post operatively and there can be false positive results.  In general, PET scan information in this setting would not be considered in isolation.  It may be compared to a CT scan and/or it could lead to a biopsy.  Your doctor will be best equipped to make that recommendation.  You may also discuss with your doctor how this information may (or may not) impact your treatment moving forward.  If you are concerned, another option is to obtain a second opinion from another breast oncologist.
3 Comments
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25201_tn?1255584436
All of my physicians believe that PET scans show way too many false positives. Also that finding metastises in this manner does not afford a pt. one more day of survival than when it is found by the occurance of symptoms.
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Avatar_f_tn
I'm sorry, but you people (your colleauges and yourself) see these images everyday, duh...they're seeing something in yours and they know you.  Get another opinion.
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