Post Chemo CT-Scan: What tests are usually done after chemo?
My wife has almost completed her chemo and the doctor has ordered a CT-Scan. Originally he wanted a PET scan but insurance wouldn't pay. Is it normal protocol to order a CT-Scan shortly before the end of chemo? I heard that there are often many false positives and negatives and that the scan doesn't tell you much. She was diagosed with Stage 1 PR+ ER+ HER- last December and had surgery to remove one microscopic tumor. We opted for chemo because the Oncotype score was high. The PA said something about a baseline but I am confused if this is the right way to go.
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Here’s what Mayo Clinic says/does:
I was diagnosed with a DCIS (Stage 0, grade 3) via a routine mammogram at my local clinic. When I went to mayo clinic for a second opinion, they did a routine MRI and found a second cancer… an invasive (Stage 1A, grade 3, triple negative). Oddly, the DCIS did not show up on the MRI… and the invasive did not show up on the mammogram. I never had a CT scan or a PET scan. From the link I provided, it looks like maybe these are done to check if the cancer has spread to other parts of the body? Perhaps a further conversation with your doctor and/or a second opinion. (I would opt for an MRI. ) Best of luck to you and your wife.
When I was first diagnosed the surgeon mentioned the possibility of a breast MRI but discouraged it as having the possibility of false positives. I elected to have it anyway, but the results were never discussed with me so I assumed they found nothing new. A CT and pet scan were also done at the same time. I'm now 3 years past diagnosis, 2 years past two lumpectomies, and and 19 months past chemo and radiation. I just last week asked my new oncologist (who is younger and affiliated with the state university health facility) about a new pet scan or CT scan. He replied that they too often showed false positives. He relies strictly on blood draws to detect a reoccurance.
Does he do any special bood work or just the basics and/or tumor markers? Does he rely solely on blood work or also do mammogram or ultrasound? There are false negative and positive possibilities with a lot of this stuff, including a point-in-time blood specimen that was drawn incorrectly or mishandled or even affected by recent diet but not representative of mean (average) values. So the overall picture is usually drawn by an array of data points. The good news is that blood work can be retested and there's no additional radiation exposure.
He relies strictly on the twice yearly blood draw looking for a particular marker, and naturally a yearly mammogram. My previous oncologist did the same but also ordered a chest x-ray. While participating in a clinical study for neuropathy I questioned one of their oncologist about the yearly chest x-ray, and she explained that it was no longer viewed as being beneficial and was no longer being recommended in order to cut radiation exposure.
I am questioning the squishy thing? You certainly don’t need mammograms less than the average woman. We all hate them and scar tissue from lumpectomies doesn’t make that better for sure, but there is no way I would agree to blood work only. Tumor markers are just not enough, if they were, no one would need a mammogram.
Are you getting mammograms annually?
Yes, sorry I forgot to mention it. Seemed like a given, I guess.