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What does PET scan showing lesion in lung indicate?

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Internal Medicine Specialist
Practicing since : 2000
Answered : 1417 Questions
Question
I have a friend - a life-long smoker - who had a breast cancer diagnosis five years ago, and one mastectomy. Two years later, she had a second mastectomy when a lump was found, even though the lump was not confirmed as malignant until post-op lab work was done on the mass. Now 1 1/2 years later, she was hospitalized for pancreatitis and during a CAT scan, a lesion was discovered on one lung. The oncologist wants to do a full MRI to check for other mets, and to do a lung biopsy. The insurance company has declined twice to cover it. I suspect her breast cancer has spread to her lung and pancreas, and apparently, she has some swelling of lymph nodes near her esophagus. My friend is sure it's lung cancer. What is her prognosis and can you shed light regarding the reason the mri test was declined?
Posted Wed, 13 Aug 2014 in Cancer
 
 
Answered by Dr. Sudhir 45 minutes later
Brief Answer:
MRI is not ideal investigation.

Detailed Answer:
Hello,

For lungs MRI is not ideal investigations.Either she should get CT scan for lung lesion or if entire body is to be screened for cancer than PET scan is ideal.

Insurance company might have declined on this grounds or that she was smoker life long.Having a talk with them can clarify this.Ideal would be to get them to give you a written reason for not covering such investigations.

If PET shows one lesion only in the lung then she can opt for excision biopsy and if there are multiple lesions at different locations then she goes for nonsurgical treatment.

Breast cancer can spread to lungs but not pancreas.

Prognosis- if the lesions in lung is cancerous and nodes are also involved , then she might have option of chemotherapy and to some extent radiation. I would say the guarded prognosis would to in the range of moderately severe.In case you are looking in terms of duration, then its difficult to predict it at this moment , particularly without investigations.

Hope this answers your question.Regards
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