can a low white blood cell count be a symptom of early mets to lung?

[survivor07]

I am having surgery on my ankle next week and the cbc came back with low lymphocytes and nuetrocytes, and high monocytes. I also have 3 tiny non calcified nodules in right lung and a few tiny "reactive" superclavicle lymph nodes.
Could they be related?
Can Tamoxifen cause a low white cell count?

[survivor07]

Hi!

Yes, I was diagnosed with Breast Cancer in 2/07. Had lumpectomy, radiation and now Im on Tamoxifen.

I broke my ankle in 8/07 and have been in pain since. ('07 was a rough year for me!)Anyway, an MRI showed a "non union" bone and possible tendon damage, so my orthopaedic surgeon wanted a blood test and an ekg before he does surgery.

My oncologist is watching some new non calcified nodules in right lung and I have some "reactive" right supraclavicular nodes, so I was wondering if it could all be related.

Thanks for your answer.

[Fernando Roque, MD]

Hi.  Before answering your question, I would just like to ask: why are you having surgery on your ankle? Is it cancer-related surgery?  I've read your profile and as I understand, you're a breast cancer survivor, right?

I don't think there's a relation between your lung nodules and the decrease in white cell counts, nor is the low white cell count indicative of lung metastases.  I don't know your entire treatment history, but the low white cell count may be a late byproduct of your prior treatment (chemotherapy or radiotherapy).  As far as I know, tamoxifen also does not usually cause low white cell counts.