How significant are liver lesions with bc?

[katarina777]

Before my mastectomy this past December, I had an MRI. The positive lymph nodes did not show up, but it showed two lesions in the liver lighting up. They did  not seem too worried, and I should also mention that I had chemo before surgery. Then, in February of this year, I had a CT scan in preparation for Radiation, and it showed three lesions in the liver. Again, it did not seem that my doctor was too worried and he suggested I need a follow up scan in six month. I had a CT scan last week and I asked for the results to be sent to me as well. I just received a call, and there seems to be a little problem because the oncologist is on vacation and they cannot send me a copy of the test results until he signs off on the paper. i asked the nurse if she could tell me if it was normal, or not, and she said that she really did not know, and I believe her. since my 'other' oncologist just died in a climbing accident, she does not know my history, and even if she went through my charts, she would not know what's going on. So I asked her if perhaps my radiation oncologist could let me know and the nurse said, that she was not sure since she did not order the test, but that she thinks it may still work and she would call me back, knowing of course that I was anxious about the results and don't want to wait ten days before I find out. I feel that if the radiation doctor had thought there was nothing of interests, surely the nurse would have called me back.  Even more likely, she did not have a chance to go over the results.

Anyway, my question is how often are those lesions something else than mets from the breast cancer, and what else could they be?

I am at very high risk for metastasis, but I have not felt ill in any way, so I don't know what to think.

Any advice? i would surely appreciate it. thanks, kat.

[katarina777]

Thank you, Dr. Paul On the CT scan report from December, it says: At least three low density liver lesions, the largest 1cm. MRI with contrast is recommended. (which I already had had, but niot specifically for the liver)  From the MRI scan, ultrasound was recommended and there were only 2 lesions seen and smaller. The pathologist does not know if these are possibly metastatic, or cystic. He mentions that there is poor contrast opacification of the solid organs. small bilateral pleural effusion al;sp seen. One is one low density lesion, and another may have some peripheral enhancement. (The lighting up was mentioned on the MRI report)

I was worried I may need a liver biopsy and is it true that they are very uncomfortable? although a PET scan was never mentioned anywhere, or to me, that sounds like a good thing to know, so thank you.

PS: can chemo cause cysts, or lesions? it says on the report than none of these findings were present in 2004.

[PaulMD]

Hi there.

There are characteristic lesions in the liver that can point out to a possible malignancy or metastatic spread.  If the liver lesions are mostly cysts, then these are unlikely to be cancerous.  If these are solid or with irregular edges that lights up very much on CT scan, then this can be indicative of malignant spread.  However, there is one reliable test to see if the liver lesions are indeed malignant or not.  And this is the PET scan test.  The PET scan will assess the metabolic activity of the lesions and eventually tell us if the lesions are cancerous or not.

I suggest that you discuss this option with your doctors once you get to meet them.  Indeed, any lesion in the body in a background of cancer should be worked up and treated as if this were malignant until proven otherwise.

Regards.