HER2 mets in my thyroid?? Questions.

[schoolteacher]

I have to go next Thursday to see a doctor about my thyroid. The SUV on it from my recent PET/CT was 4.5. It will be interesting to see if my HER2 count is high in this area. My thyroid has always had a high uptake of glucose when my PET-CT scans have been done. This time it has gone up.

Going to have a biopsy soon to check for BC mets.
Anybody here ever had this? Or know anything about it? What should I ask the doctor? What kind of procedures?

I had my thyroid biopsied in 1998. I always wondered if the goiter or mass I have in it caused my BC. I take a thyroid supplement.

Amelia

[Cal-Gal]

Hi Amelia-
No, have not heard of this-what is SUV range for PET scans?

[Jackie07]

[SUV = standardized uptake value]

PET Scan IDs Breast Cancer Spread

Before Surgery, Technique Points to Cancerous Lymph Nodes
By Daniel J. DeNoon (http://www.webmd.com/daniel-j-denoon)
WebMD Health News




Aug. 21, 2006 -- Before surgery, a PET-scan technique can detect the spread of breast cancer (http://her2support.org/diseases_and_conditions/breast_cancer.htm)breast cancer to a woman's lymph nodes, Cedars-Sinai researchers find.
When breast cancer (http://her2support.org/diseases_and_conditions/cancer.htm)cancer spreads to the lymph nodes, those lymph nodes must be removed. By pointing doctors directly to cancerous lymph nodes, the new technique could help some women avoid a second surgery.
The technique involves injecting a woman with a glucose-like radioactive tracer called FDG for imaging. Cancer cells grow very fast, and need more food -- glucose -- than normal cells. So they gobble up more FDG than other cells, and thus shine more brightly on PET (positron emission tomography) imaging scans.
But Alice Chung, MD, Edward H. Phillips, MD, and colleagues did not visually examine FDG-PET scans taken of 51 women with invasive breast cancer. Instead, they calculated how much FDG their lymph nodes absorbed -- a value called the standardized uptake value or SUV.
Over a certain SUV threshold, positive PET scans were 100% accurate in predicting cancer in the lymph nodes. However, it was only 60% sensitive. This means that it missed some cancerous lymph nodes.
"FDG-PET is not a perfect test," Phillips said, in a news release. "As we continue to see advances in technologies, I believe we will be able to identify smaller and smaller tumors with greater accuracy."
The researchers say they don't think FDG-PET scans should replace other techniques, such as sentinel-node biopsy, that help doctors determine whether a woman should undergo lymph node removal. But they say the technique puts another arrow in the quiver of surgeons working to make breast cancer treatment more effective and easier on patients.

[WebMD 2006]

[StephN]

I have not known anyone to have BC mets to their thyroid, so I hope you are not going to be the first.

Maybe someone else here has some answers you seek.

[Sheila]

You said your thyroid was biopsied back in 98, and what were those results? I would think mets to the thyroid are rare, I have never heard of this, but as we know, never say never. I would think that a new or old primary in the thyroid would be more common, and if so, thyroid cancer is highly curable....found often in younger people.
Hoping all turns out normal.

[schoolteacher]

Shelia,

Thank you for responding to this post. My results were b9. I called Stephanie Saturday to talk with her.

When I got my appoint to see the thyroid doctor, on the appointment it said: to evaluate thryroid nodule, PET positive seen on PET scan for breast cancer. I did not know until last week that you have HER2 cells in your thyroid.

I call the doctor's office to see if they will do the biopsy Thursday after my appointment. She said, "They would." I hope they do.

I am worried about my HER2 serum test being 23.2. It has never been this high since I had my masecttomy.

The doctor says wait and see.

I am hoping the vaccine has made my level increase. I am waiting to hear from the research nurse from the University of Washington if the vaccine can increase the level.

If you have any suggestions. Please let me know.

Amelia

[hutchibk]

I just had bc mets to my pituitary gland in October (radiated and gone)... but it could be thyroid issues/nodules/pre-thyroid cancer and not bc mets. It could be a number of things.

[schoolteacher]

Hutchibk,

Thanks for the reply. You are one of the strongest women on the board. I really admire how proactive you are.

If you have any suggestions about what I should do, I would appreciate the advice. This time tomorrow morning, I will be on my way to the doctor. I called yesterday and asked for the biopsy tomorrow.

The oncologists has already told me that I will have to take radiative idodine if the biopsy shows cancer.

I am concerned about the two nodules in my lungs. He wants me to wait until April or three months to do another PET scan. He says, "He looked at the scans and the nodules did not look not look B9."

Amelia

[Margerie]

Amelia~

When I had a CT to set up radiation therapy, the rad onc told me I had nodules on my thyroid and I should check them out after treatment. I had an ultrasound (result- lots of nodules) and then an ultrasound-guided biopsy of the largest nodules.

There is a very good chance it is benign thyroid disease.

[schoolteacher]

Thanks for your reply. I hope and pray there is nothing in my throat.

Has your HER2 level gone up after doing the vaccine? I hope that is what is throwing my level up to 23.2.

Amelia

[tricia keegan]

Amelia, I'm sorry I can't help regarding this but wanted to send good wishes for b9 results to you:)

[schoolteacher]

Thank you Tricia. Hope you are feeling well.

AMelia

[hutchibk]

It sounds like you are getting great advice from everyone here... I can't think of anything to add other than I had two cats treated for thyroid disease with the iodine. Ha. They came through it just fine!

Also, a friend of mine had that treatment a few years ago and it wasn't that difficult except that she was quarantined in her hospital room for 3-5 days while she was considered radioactive... and she got bored. She's doing great now. She is on synthetic thyroid medication forever.

Best of luck and let us know what the tests yield!

[Cannon]

Just wanted to say - a neg biopsy is not considered definitive in thyroid - my dr. told me you could have 10 neg biopsies and still have thyroid cancer. Guess what - I had 2 negative biopsies with my "multi-nodal" goiter. Removed it anyway - cancer. One year later, my sister had exactly the same thing. This was pre BC by 2 years.

[kk1]

Hasimoto's thyroid disease also shows on a PET scan. My PET scans always light up my thyroid as I have this disease. I posted a link below. Might request the simple thyroid antibody blood test to see if this might be the cause before doing biopsies ect. Many women have this thyroid disease and are unaware as it causes few symptoms in the early stages. My Onc also says her2 mets to the thryoid are unlikely.


(http://javascript%3Cb%3E%3C/b%3E:AL_get%28this,%20%27jour%27,%20%27Ann%20Nucl% 20Med.%27%29;)
Ann Nucl Med. (http://javascript%3Cb%3E%3C/b%3E:AL_get%28this,%20%27jour%27,%20%27Ann%20Nucl% 20Med.%27%29;) 2007 Aug;21(6):325-30. Epub 2007 Aug 27.
Diffuse and diffuse-plus-focal uptake in the thyroid gland identified by using FDG-PET: prevalence of thyroid cancer and Hashimoto's thyroiditis.

Kurata S (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Kurata%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Ishibashi M (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Ishibashi%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Hiromatsu Y (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Hiromatsu%20Y%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Kaida H (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Kaida%20H%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Miyake I (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Miyake%20I%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Uchida M (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Uchida%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract), Hayabuchi N (http://www.ncbi.nlm.nih.gov/pubmed?term=%22Hayabuchi%20N%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVAbstract).
Division of Nuclear Medicine, Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. skur@med.kurume-u.ac.jp
OBJECTIVE: To investigate and evaluate the prevalence of incidental thyroid diffuse and diffuse-plus-focal fluorine-18 fluorodeoxyglucose (FDG) uptake in healthy subjects who underwent cancer screening on positron emission tomography (PET) scan, and also to evaluate the prevalence of thyroid cancer and Hashimoto's thyroiditis. METHODS: We carried out a retrospective review of 1626 subjects who underwent PET scanning at our institution. Diffuse uptake was defined as FDG uptake in the whole thyroid gland, whereas diffuse-plus-focal uptake was defined as a thyroid lesion with both diffuse uptake and focal FDG uptake. The maximum standardized uptake value of the thyroid lesions was recorded and reviewed. In each selected subject with positive thyroid FDG uptake, serum thyroid-stimulating hormone, thyroid hormone, and thyroid antibodies were measured. Fine needle aspiration cytology was performed on patients with a definite nodule using ultrasonography. RESULTS: Twenty-nine subjects (1.78%) were identified as having either diffuse FDG uptake (n = 25, 1.53%) or diffuse-plus-focal FDG uptake (n = 4, 0.24%). All subjects with diffuse FDG uptake were diagnosed as having Hashimoto's thyroiditis. In 1 of the 25 subjects with diffuse FDG uptake and two of the four with diffuse-plus-focal FDG uptake, histopathologic diagnosis showed papillary thyroid carcinoma associated with Hashimoto's thyroiditis. However, PET scan did not detect papillary carcinoma associated with Hashimoto's thyroiditis in one of the three subjects. CONCLUSIONS: Our results suggest that although diffuse FDG uptake usually indicates Hashimoto's thyroiditis, the risk of thyroid cancer must be recognized in both diffuse FDG uptake and diffuse-plus-focal FDG uptake on PET scan.

[schoolteacher]

I want to thank all of you for your information.

I have three nodules. One large one and two small ones. The doctor did a total of 11 fine needle biopsies.

I do have Hashimoto disease. I have had it since 1998. I tried talking to the doctor about my thyroid abnomaility causese my BC, but she did not have much to say about it.

Cannon, thanks about telling me about having your thyroid taken out. I am going to consider doing this.

Amelia

[Cannon]

When I got bc 2 years after thyroid cancer, I asked all my doctors if there was a relationship. The answer was, not one we know of, but probably eventually we will find one that applies to some people. Made sense to me - not that one caused the other, or that the treatment for one caused the other, but that I have crappy genes/immune system and was unlucky. My endocrinologist told me about a patient he had who had 5 unrelated and unusual cancers - a youngish woman like me. And then she was fine.

[schoolteacher]

I should know my results tomorrow. The big question now is: Do I leave my swollen thyroid in my neck?

Amelia

[Shobha]

Amelia,

praying for your clean, good results tomorrow! Take care.

shobha

[schoolteacher]

Thank you Shoba. I am going to ask for anothe HER2 test tomorrow and a brain MRI.

Amelia

[tricia keegan]

Positive thoughts winging their way to you for good news today Amelia:)

[schoolteacher]

I got the results of my biopsies, and they were B9.

Now he wants to biopsy the place in my lung.

Amelia

[StephN]

That is GREAT news on the thyroid nodules.

Process of elimination. *Something* is driving up your HER2 serum result.

Let us know when you have the lung biopsy scheduled.

Take care.

[WolverineFan]

Amelia,

How did your results come out? Thinking of you.

[Jackie07]

Amelia,

Glad to hear the good news. Do remember to let us know when your lung biopsy is scheduled. We'll be thinking of you.

[caya]

Great news Amelia. Hoping for the same results in your lung.

all the best
caya

[Shobha]

Amelia,

Thanks for sharing the good news on the thyroid. Praying for the same good results for the lung biopsy!

hugs,
shobha

[schoolteacher]

Thank you for remembering me. I had another HER2 serum test last Thursday. I should know the results this Thursday. I hope it has gone down. My tumor marker fell down to 19. It was 22 in December.

I have a brain MRI on February 15 at 8:30 in the morning, and the lung biopsy is on February 16. I need to schedule to see the gyno this week too, to see if the Tamoxifin has increased the lining of my uterus.

My estrogen level is 5. I hope this is what has driven my HER2 level up.

God Bless all of you.

Amelia

[tricia keegan]

I'm so glad to hear the good news Amelia, and really hope the lung biopsy will be just as good. xx

[Midwest Alice]

Best of luck Amelia, so glad you are requesting the additional testing. Alice