PET shows hypermetabolic activity: What does it all mean?

Posted by oakhillbull @oakhillbull, May 1, 2019

I am new to this site looking for information I received yesterday from my oncologist.
I have been on Ibrance/Letrozole for 3 years 2 months. Have bone Mets spine and ribs. I had a PET scan last week and it showed no hypermetabolic activity. Onocoligist stayed a lot us not known about scarring over. We decided to stay on the Ibrance/letrozole and watch. I don’t understand scarring over. What happens under the scars? Am I cured? I was told when diagnosed I would never be cured. I’m just so confused and today looking for more information when this occurs. Has anyone had this happen to them? Thanks for anything you can tell me.

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

Hi @oakhillbull and welcome to Connect.
You may also be interested in joining this discussion:
– Metastatic breast cancer: Anyone else? https://connect.mayoclinic.org/discussion/metastatic-breast-cancer-to-the-bone/

I can see that you have quite a few questions after your appointment with your oncologist. I'm not a doctor, but I might be able to help explain a few things that you've mentioned.

Regarding metabolic activity.
"A PET scan (positron emission tomography) works to identify areas of hypermetabolic activity anywhere in the body. A radioactive substance is given to the patient and this attaches to glucose, which is attracted to cells that are hypermetabolic. When the scan is done, these areas "light up." Often, but not always, cancer cells fall into this category of being hypermetabolic. In addition, not everything that is hypermetabolic is cancer."

It sounds like there was a significant amount of hypermetabolic activity shown on the PET scan results. The scan cannot differentiate between cancer cells or other situations like infection or inflammation that may be causing this activity. It also sounds like the scar tissue was making it a challenge to get a clear idea of what is going on. But it sounds like something is going on.

Did your oncologist order more tests to investigate?

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Recently on my PET Scan, it showed hypermetabolic upper abdominal aorta caval lymph node and I’m getting a repeat CT scan to see if the node is stable or has grown. It’s only been 6 month since my last scan. Is this cancerous or maybe just inflammation? My oncologist made it sound like the node is in a difficult are to biopsy, if they have to.

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@bcsurvivor

Recently on my PET Scan, it showed hypermetabolic upper abdominal aorta caval lymph node and I’m getting a repeat CT scan to see if the node is stable or has grown. It’s only been 6 month since my last scan. Is this cancerous or maybe just inflammation? My oncologist made it sound like the node is in a difficult are to biopsy, if they have to.

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Hi @bcsurvivor, welcome to Connect. I can imagine that the PET scan result has you feeling anxious. Remember not everything that is hypermetabolic is cancer. Am I correct that this was a routine follow-up scan that detected the activity? What type of breast cancer did you have?

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@bcsurvivor

Recently on my PET Scan, it showed hypermetabolic upper abdominal aorta caval lymph node and I’m getting a repeat CT scan to see if the node is stable or has grown. It’s only been 6 month since my last scan. Is this cancerous or maybe just inflammation? My oncologist made it sound like the node is in a difficult are to biopsy, if they have to.

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Thank you for your reply! I am a 7 year breast cancer survivor and finished chemo/herceptin 5 years ago. I was Her-2 Positive and yes this all makes me a nervous wreck!

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@bcsurvivor

Recently on my PET Scan, it showed hypermetabolic upper abdominal aorta caval lymph node and I’m getting a repeat CT scan to see if the node is stable or has grown. It’s only been 6 month since my last scan. Is this cancerous or maybe just inflammation? My oncologist made it sound like the node is in a difficult are to biopsy, if they have to.

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@bcsurvivor, how are you doing? When is the repeat CT scan scheduled for?

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@bcsurvivor

Recently on my PET Scan, it showed hypermetabolic upper abdominal aorta caval lymph node and I’m getting a repeat CT scan to see if the node is stable or has grown. It’s only been 6 month since my last scan. Is this cancerous or maybe just inflammation? My oncologist made it sound like the node is in a difficult are to biopsy, if they have to.

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bcsurvivor @bcsurvivor That showed up on my PET scan recently in several areas and I was told by my oncologist that it is normal, but I'll need a follow up PET scan in 6 months due to the neuroendocrine diff on my second tumor.

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Hi, I had a PET scan and it showed hypermetabolism in my internal mammory lymph. I have a pea size lump in my left breast. I just found it. However when I lay down it goes under my rib. I have to have my last CAD I don't think they are catching that pea thing because of how it goes back under the rib. My question is did anyone have a pet scan that showed hypermetabolism? Should I be worried?

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@stephers911

Hi, I had a PET scan and it showed hypermetabolism in my internal mammory lymph. I have a pea size lump in my left breast. I just found it. However when I lay down it goes under my rib. I have to have my last CAD I don't think they are catching that pea thing because of how it goes back under the rib. My question is did anyone have a pet scan that showed hypermetabolism? Should I be worried?

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Hi @stephers911, deep breath and one step at a time. You'll notice that I moved your message to this existing discussion where @oakhillbull @bcsurvivor @trixie1313 asked similar questions about the meaning of hypermetabolism activity showing on a PET scan.

I'll repost this regarding metabolic activity.
"A PET scan (positron emission tomography) works to identify areas of hypermetabolic activity anywhere in the body. A radioactive substance is given to the patient and this attaches to glucose, which is attracted to cells that are hypermetabolic. When the scan is done, these areas "light up." Often, but not always, cancer cells fall into this category of being hypermetabolic. In addition, not everything that is hypermetabolic is cancer."

A PET scan is only one step in the diagnostic process. When do you have an appointment with your oncologist to discuss the results of the PET scan and to talk about the step or test?

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I had a pet scan it showes I have lung cancer in my right lung . It also said my abdomen and pelvis and bones are clear but did not mention my breast what does that mean

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@pbemesderfer

I had a pet scan it showes I have lung cancer in my right lung . It also said my abdomen and pelvis and bones are clear but did not mention my breast what does that mean

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Hi @pbemesderfer, were you diagnosed with breast cancer and now the most recent PET scan shows that the cancer has spread to your lungs?

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