CT Scan standard for stage 2?

KaiM · 03-10-2012, 09:24 AM

It really is just my own curiosity that brings this up because my doc had to fight with my insurance company after my surgery for a CT scan. I guess they don't approve them generally for someone who comes out of surgery looking like a stage 2 patient. The CT scan revealed I had mets, but I often wonder if they would have treated me as a stage 2 patient had the scan not been approved. Anyone else almost or been treated as the wrong stage?

Delaney · 03-10-2012, 09:32 AM

Thankfully you have such a good Oncologist as usually scans are not done without specific symptons at such an early stage. And now you will get the correct treatment early. Bad luck on having mets but at least you know what you are dealing with now and mets doesnt seem to be the full stop they once were, there are so many people treating this as a chronic disease now. I hope we all inch along and eventually get a big break from treatment. Stable or NED will do just fine. Best wishes.

JennyB · 03-10-2012, 09:40 PM

I would think that CT scan is standard for initial diagnosis of Her2 breast cancer as size of tumour doesn't necessarily equate to stage? It's not as if a Stage 2 diagnosis then goes through the 3 stages en route to 4 it is a straight jump and not predictable either.
I was not given the choice of whether to scan or not so I would presume it is standard of care with the Her2 diagnosis in Australia.
Any future scans are only done here with symptoms or 'ear bashing' of oncologist in my case!!

Jenny

Becky · 03-11-2012, 05:49 AM

Getting scans at Stage 2 is loosy goosy here in the USA.

I think it depends on your doctor and.... stage 2 means alot of things. First, there is Stage 2A and 2B. Also, you can be Stage 2 and have a stage 2 size tumor but have no involved lymph nodes or you can have a tiny (stage 1 size tumor) but are Stage 2 because lymph nodes are involved (such was my case).

Because I was Stage 2A but was Stage 2A because of positive nodes (and was Her2 prior to Herceptin), I was scanned. I knew of another woman who was Stage 2 (same doctor as me) but nodes were not involved and was not. I figured in my onc's mind it was the nodes.

CoolBreeze · 03-11-2012, 01:28 PM

I was dx'd at Stage II originally and had no scans. The oncology guidelines don't recommend them unless you are symptomatic. Four months after I finished treatment (six rounds of TC and a year of Herceptin) I found 3 tumors on my liver, several cms in size. They had not been there at the end of treatment because I had a symptom and was scanned - when the problem continued I was rescanned and there they were.

I wonder if they were there initially and the first rounds of tumor shrunk them and they grew when I was done?

We'll never know and it actually doesn't matter in the end.

chemteach · 03-12-2012, 06:50 PM

Well that's crappy! SOS when I'm finished with the Herceptin, do I ask for a scan? Ugh....!! I thought of each of you today as I was hiking the Texas hill country Enchanted Rock when I felt a cool breeze and it was healing and invigorating and refreshing to be outside and alive and away from this disease that tries to control who we are and who we become. I cannot let it take over. Not yet.... Will it?

Kellennea · 03-13-2012, 12:49 PM

No scans for me either, and believe me... I've asked. I am stage 2, no node involvement so my oncologist will not order one.

With that said, I get a mammo of my "bad breast" every six months and then every year they do a mammo of both as well as an MRI.

I keep asking, and I keep getting denied.

greenacres · 03-13-2012, 02:10 PM

Hi there! Prior to surgery I was estimated at a "Stage 1", but knew I was Her2+++, ER-/PR-. In between excisional biopsy I had a PET scan ordered by my oncologist. It revealed a few areas of uptake, but nothing of concern apparentally because they never said anything about it (the uptakes were in the nasopharynx and a joint - arthritis probably). Then I had my surgery and final diagnosis was the same as thought. But yes, my insurance company approved my PET scan. I've never had a CT, but let me tell you those uptakes still concern me to this day because they said "we'll monitor those" and the report says the same. But now they tell me I don't need any scans unless I am having symptoms. HMMMFFFF!

I think this wasn't standard, not sure. I am in Central WI at the UW Cancer Center. I'm sure it was because I was Her2+++ I was sent for the PET. GOOD LUCK to you.

Kellennea · 03-13-2012, 02:29 PM

I dont think its standard protocol to scan because of HER2 + status, or I think we all would be scanned regardless of node involvement or not, at any stage.

My Oncologist, like Becky's only scans at stage II if there is node involvement. Which still stinks.

tricia keegan · 03-13-2012, 03:27 PM

I was stage 2A but only had a bone scan due to the positive nodes and otherwise my Onc only orders scans with symtoms.

mschwab · 03-14-2012, 03:40 PM

My surgeon ordered scans because she could feel inflamed lymph nodes. It was before my lumpectomy and I hadn't been staged yet. Luckily they were clear, and any additional scans will be based on symptoms.

Maryann

CoolBreeze · 03-14-2012, 07:53 PM

I wouldn't ask for a routine scan after treatment. First, you get a lot of radiation with them and why do something that could cause cancer? Second, they don't really show anything until it's large enough to already be symptomatic.

Personally, I would just live like a person who had completed cancer treatment and was a Survivor, until told otherwise.

If it comes back, you'll know it. There isn't any clinical benefit to finding it early.

Here are the clinical guidelines, if you ever want to know if your doctor is treating you appropriately:

http://www.nccn.org/professionals/ph...guidelines.asp

They don't HAVE to stick to them but many do.

KsGal · 03-15-2012, 02:02 AM

It must be standard procedure with my doctor, and I didn't have any problems with insurance. I guess it may have been because I had three positive nodes? I had a CT scan before starting chemotherapy in December, and I was a stage IIB at that time (we thought). Turned out I had several liver lesions and was a stage IV. Really, really disappointing to go through, but glad I found out.

Jackie07 · 03-15-2012, 02:45 AM

My recurrence was overlooked for almost 4 years because they thought the shadow on the films was 'scar tissue'. Luckily I had requested that 'early' mammagram through my breast surgeon and she realized it was new growth out of the lumpectomy site.

Still, she talked as if I were to blame because I was her "first patient to have recurred!"

Mine was also a stage 2, and I believe I was given a CT scan after the surgery.