Pulmonary Nodules - anything to worry about?

[Monica]

Hi,
I have had a lot of problems with lung nodules coming and going. They found a nodule about 7 months ago. Had another cat scan 3 months later and it had disappeared, but then another one showed up. So, 3 months later I had another cat scan, and that one was gone but this time another larger one showed up which was 1.3 cm which is relatively big. It also looked very suspicious, and my doctors were worried. So, I went through a VATS procedure and it turned out to be only some sort of undefined infection. Other than a cold (with no fever) I had been health throughout this period. So to be honest, my feeling at this point is I don't want to get any more CAT scans.

More importantly, the one thing that I have learned is that a lot of nodules that look suspicious are often benign. In addition, from what I understand there is a stronger argument to take it out, if it is a solitary nodule. If there is more than one nodule, I think a wait and see is more common.

I know the waiting and not knowing is terrible. For me, I just wanted to know - whatever the answer was.

Best,
Monica

[Lani]

help put your mind at ease (or at least make you a bit less anxious):

2008 Abstracts Home
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Indeterminate pulmonary nodules in breast cancer: Clinical significance and management.

Sub-category:

Adjuvant Therapy

Category:

Breast Cancer--Local-Regional and Adjuvant Therapy

Meeting:

2008 ASCO Annual Meeting




Abstract No:

617

Citation:

J Clin Oncol 26: 2008 (May 20 suppl; abstr 617)

Author(s):

B. Lee, A. Lim, R. C. Leonard, J. Lewis, C. R. Coombes, J. Stebbing

Abstract:

Background: Increasing numbers of patients with early breast cancer undergo routine staging using computerized tomography (CT). Those in whom indeterminate pulmonary nodules are visualized without the presence of other potentially metastatic lesions represent a clinical dilemma of whether they should be managed as early breast cancer or metastatic disease. This study sought to investigate the incidence, clinical characteristics and outcomes of patients with indeterminate pulmonary nodules in breast cancer, which has important implications for their management and also entry into clinical trials. Methods: Medical records of individual breast cancer patients who underwent thoracic CT scans between the years 2002 to 2007 were analyzed and those with obvious metastatic disease were excluded. Patients were identified via the radiology database by searching for the following terms: suspicious lung metastases, and/ or indeterminate nodules. Results: Out of 2,578 patients scans, we identified 34 cases (1.3%) with indeterminate pulmonary nodules without evidence of disease elsewhere on CT scanning. We categorized these cases to the size of the nodules. At a median follow-up of 13.5 months, there were no changes in lesion size in 86% of the patients with a solitary nodule smaller than 1cm, and 89% with multiple sub-centimeter nodules. In contrast, 100% of cases with pulmonary nodules larger than 1cm had progressed at follow up (ψ2, p=0.004). Conclusions: Breast cancer cases with sub-centimeter indeterminate pulmonary lesions and no evidence of metastases elsewhere are unlikely to represent metastatic disease. Treatment with curative intent or entry into clinical trials should not be excluded.

[TSund]

Monica,

I am noting that you are not taking hormonal drugs, despite ER+. Is this a personal choice? Are you doing other "natural" things to help the ER factor? Sorry I'm going off on a tangent here.

THanks,

Terri