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Can progression on PET CT scan be scar tissue and not Cancer?

Posted by allwync88 @allwync88, Feb 28 6:42pm

My mom was diagnosed with Metastatic Breast Cancer in December 2022. Her tumors were ER+ and HER2+. She underwent 18 cycles of Paclitaxel, Trastuzumab every 3 weeks and Zoledronic acid every 4 weeks. She was on Letrozole 2.5 mg every day.

Her scans were stable till November 2023. In February 2024 her scans revealed progression in her bones.

Below were the findings from her PET CT scan.

1. Increased FDG uptake is noted in the marrow and lytic-sclerotic lesions involving multiple bones of axial and appendicular skeleton.
2. Increase in number and metabolic activity of the skeletal lesions.
3. No significant interval change in the primary breast lesion and axillary nodes.
4. Decrease in size of the non FDG avid splenic lesions.
5. No metabolically active disease elsewhere in the body.

Her oncologist wants to change her treatment line and he has given us 2 options.

1. TDM1
2. Oral pill + Trastuzumab
He also asked us to shift to Denosumab from Zoledronic Acid.

My question was could the progression on her PET CT scan be scar tissue and not cancer?

The oncologist did not look at the film, just checked the report and wanted to change the treatment line.

I am very worried and require help from expert members in the group.

Interested in more discussions like this? Go to the Breast Cancer Support Group.

Mentor
Chris, Volunteer Mentor | @auntieoakley | Mar 3 10:17am

@allwync88 sadly none of us are doctors, we are patients like your mom. That being said I can try and translate a little. Lytic lesions are where the cancer causes a hole in the bone. My husband has this type of lesions in his bones so I am familiar. Your oncologist probably just read the read the report because the radiologist is the expert at reading the scans and they write a report for your doctor.
I have received quite a few of these reports over the years and it sounds like they found a change in your moms cancer pretty early, and are changing the drugs since the old ones are not being as effective anymore.
I cannot really give you any more information about it, since all I can really do it translate what you told me a bit. I know how scary this is, I hope it helps.
How are you feeling about all of this, how is your mom feeling? Has she started the new regimen yet?

REPLY
1 reply
allwync88 | @allwync88 | Mar 3 6:02pm
In reply to @auntieoakley "@allwync88 sadly none of us are doctors, we are patients like your mom. That being said..." + (show)
@auntieoakley

@allwync88 sadly none of us are doctors, we are patients like your mom. That being said I can try and translate a little. Lytic lesions are where the cancer causes a hole in the bone. My husband has this type of lesions in his bones so I am familiar. Your oncologist probably just read the read the report because the radiologist is the expert at reading the scans and they write a report for your doctor.
I have received quite a few of these reports over the years and it sounds like they found a change in your moms cancer pretty early, and are changing the drugs since the old ones are not being as effective anymore.
I cannot really give you any more information about it, since all I can really do it translate what you told me a bit. I know how scary this is, I hope it helps.
How are you feeling about all of this, how is your mom feeling? Has she started the new regimen yet?

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Thank you for replying to me.

I do not feel good. Mom has not taken it well. She took Lapatinib (5 tablets) and Capacetabine (4 tablets) yesterday and was sleeping most of the time.

The only thing I wish is that there is a cure for this terrible disease and everyone gets saved.

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