QuoteReplyTopic: Confusing PET/CT results Posted: Feb 12 2020 at 8:52am
I am a 2-time TNBC survivor (2008 & 2013 separate primary tumors-underwent mastectomies
and chemo). 3 months ago PET/CT detected suspicious nodes left underarm,
underwent biopsy-results benign. Underwent another PET/CT this
week-more nodes showed up and previous ones grew. Doctor is ordering 3
more
biopsies for suspicious nodes. Unfortunately, I only spoke with a nurse
and she couldn't
answer my detailed questions. I have Lupus and the breast oncologist
previously thought that the inflammation of nodes was a result of an
active flare. I am concerned about the subpectoral
nodes because those have NEVER lit up before.
Here are my results:
"There is interval increase in size
and number of FDG avid lymph nodes in the left subpectoral region/left
axilla. Biopsied left subpectoral lymph node with a biopsy clip measures
1.4 x 1 cm demonstrating FDG uptake with max SUV of 3.2. Additional
left subpectoral/axillary lymph node seen on image 76 series 5 more
posteriorly and superiorly measures 1.3 x 0.9 cm demonstrating FDG
uptake with max SUV of 2.7. A
1.5 x 0.6 cm subpectoral lymph node seen on image 74 series 5 also
demonstrates FDG uptake which is less than background, is suspicious as
it is increased from previous. 3 other subcentimeter left axillary lymph
nodes and 1 additional subpectoral lymph nodes demonstrate low level
FDG activity new since previous."
QUESTION:
Has anyone had these kind of results that results in a positive
malignancy outcome or not? I know that no one can predict outcomes, but I
am just curious.
6/26/08 DX TNBC, Grade III, Stage II, 0/17 nodes, KI-67 80%, BRCA-,R-mx&recon 7/08. 8/2012 mammo NED, 6/2013 DX New primary TNBC tumor L-mx&recon. Age 38
In 2010 I had a routine PET scan that found a suspicious area. The SUV was 1.5 and we were hoping it wasn't cancer. My onc ordered an MRI that identified the area as an internal mammary node. Subsequently I had to have a needle biopsy that confirmed it was a recurrence. I'm hoping your results are just because of inflammation and not cancer. Keep us posted on what you find out. Hugs.
Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15
Thank you for your response Donna. That SUV, at 1.5, is not very much at all. I am surprised. If my biopsies do come back positive, I will just be thankful that now I know and can move forward treating them.
6/26/08 DX TNBC, Grade III, Stage II, 0/17 nodes, KI-67 80%, BRCA-,R-mx&recon 7/08. 8/2012 mammo NED, 6/2013 DX New primary TNBC tumor L-mx&recon. Age 38
Knowledge is power and you have a good attitude. I always found the unknown/uncertainty was the hardest part. Were you tested for other gene mutations besides the BRCA test? They are finding many more genes associated with breast cancer than just the BRCA gene. Please let us know what they find. We are here for you and hope you get good news that it's benign.
Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15
I'm trying to ask a question as a result of a post of yours: you said that in 2010 PET has identify something of 1.5 and that was an cancerous IM node. Do you mean 1.5 cm?
The standard uptake value (SUV), also known as standardized uptake value, is a simple way of determining activity in PET imaging, most commonly used in fluorodeoxyglucose (FDG) imaging. It is also known as the dose uptake ratio (DUR).
PET scans gives results in SUV’s. Usually anything over 2.0 - 2.5 is considered malignant. If it’s under that number, it may be benign.
Positron Emission Tomography
Typically, a standardized uptake value (SUV), a quantity that incorporates the patient's size and the injected dose, that is more than 2.0 is considered to be suggestive of malignancy, whereas lesions with SUVs less than this value are considered to be benign.
You said in my post the SUV was 1.5. This was the uptake of the FDG they inject prior to the scan. While it was below the 2.0/2.5 SUV level for malignancy, it was suspicious for malignancy and required further testing for me (MRI, then needle biopsy). I was hoping that it was benign, but it wasn’t.
Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15
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