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Breast cancer. Want opinion on PET results. Is lymph node SUV from inflammation?

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Practicing since : 2004
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PET results:stage 2a idc right side node negative BC er+ her2+
my oncologists is happy with results and said is all from inflammation. Since Oct 2010 I have had a total of 5 surgeries on my breasts due to healing problems on right side where tumor was last on in August for pectoralis major repair. Right breast incision still inflamed/ a bit red compared to left on a small spot about 1 inch for which I needed hyperbaric treatment. I finished chemo in April and herceptin 2 weeks ago. I'm scheduled for final silicone implants in 3 weeks and oncologists said ok to get port out. This is my 3rd pet scan. My last pet was at the end of XXXXXXX 2011 before having reconstruction again because my expanders were taken out in Dec 2010 due to rejection from chemo. It was no mention of node but did mention residual inflammation from mastectomy 8 months earlier. anyhow, this recent pet was first after 2 extra surgeries; reconstruction and a week later pect major rupture on right requiring repair, also had restitching twice
I would like your opinion on my last PET
" bilateral implants present. slight increase in activity about implants on the right more than left. this appears diffuse and is likely postop or related residual inflammation. SUV 1.4 right vs 1 on left. above right breast implant in the axilla, there is a focus of activity with SUV 4.5 of a nonenlarged solitary lymph node. lymph node is nondiagnostic for neoplasm vs inflammation origin."
No other problems or uptake seen elsewhere.
I'm concerned about that lymph node SUV, is it from inflammation? would it be enlarged it it was bad?. My onc again said it is not to worry. but I'm still worried is cancer. she said most cancer lymph node are enlarged and this is not. I would like your sincere opinion. thanks
Posted Tue, 8 May 2012 in Cancer
Answered by Dr. Indranil Ghosh 3 hours later


Thank you for posting your query.

You had early breast cancer and have received appropriate treatment. You have come a long way through surgery, chemotherapy and herceptin for a year. I am sure you will do well in the future also.

It is unfortunate that you had to undergo so many surgeries but I am happy that it seems finally over for you.

Regarding the latest PET-CT (Positron Emission Testing - Computerized Tomography) report, I agree with your oncologist that there is nothing to worry. Lymph nodes are normally there in the axilla and may be seen in scans also. A non-enlarged lymph node with SUV of 4.5 may well be due to inflammation (probably resulting from the implants). After all, the implants are foreign bodies and can induce a lot of inflammation.

I feel that you can just continue your routine follow-up and no intervention is necessary at this point.

Hope I have answered your query. Please accept my answer in case you do not have further queries.

Above answer was peer-reviewed by
Follow-up: Breast cancer. Want opinion on PET results. Is lymph node SUV from inflammation? 10 hours later
when my onc dictated my progress on her handset, I heard her say it was because of that, i was just scared a biopsy may be needed from possible axillary recurrence but she did not even mention it. is it true that metastatic nodes are usually enlarged?
thanks again , you are the best!!, i will accept your query soon
Answered by Dr. Indranil Ghosh 39 minutes later
Hi Again,

Yes, metastatic nodes are usually enlarged (>1.5 or 2 cm). Smaller nodes are usually non-metastatic or inflammatory. I don't see any reason to go for biopsy at this stage. You may discuss the reasons at length with your doctor when you consult him personally.

Hope you recover soon.
Above answer was peer-reviewed by
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