re: liver mets

[katarina777]

I want to ask one more question about liver mets, in follow up to a previous post.
My oncologist is concerned about the three liver lesions that showed up on the CT scan, as well as a slightly prominent bile duct at the entrance to the pancreas and that is larger now than it was in January. The report does not specifically say that those lesions have grown although from the cm measurements, they seem a little larger, like by one half centimeters. One or two of then are most likely hemangiomas.

I am asking because he wants to follow up with an MRI, and I don't know if he is just being especially careful, or really thinks the test is necessary.  I mean, i am really beginning to feel sorry for my insurance company and I don't want to have any more tests than are really indicated.

So my question is: if this was metastatic cancer from the IBC, wouldn't the cancer have much more spread already in the liver and significantly have grown in almost a year?

I did ask him about the PET scan but he says that the lesions may not be large enough to should up on a PET scan for cancer.

I just want to not cost anymore than I absolutely need to. Thanks. Kat.

[mamaboulet]

Dr Paul is great. And I got my first morning giggle with you feeling sorry for the insurance companies. Best wishes to you.

[katarina777]

Thank you so much, once again. You are wonderful! I really love the way you respond to questions. Kat

[PaulMD]

HI there.

If the lesions are the same in size for the past year, then I would tend to believe that these lesions are not cancerous or are not cancer spreads from breast cancer.  However, in the light of a previous diagnosis of cancer, it is best to work up these lesions thinking this is cancer until proven otherwise.  Missing a diagnosis of metastatic cancer can indeed be fatal and this is why I guess your doctors really want to make sure (don't feel sorry for your insurance company, it's your health that matters most).

PET scan can detect at least 1cm of cancer.  If this is not appropriate then it may be prudent to still follow this up with serial scans such as the MRI.

Regards.