Lung Biopsy Language - 1263418

lmlb7665
Posts:48

Well wonderful doctors on the information website that I have turned to a number of times in the last three years. Here are the new developments:

A biopsy of the upper right lung was done on 4-17. In May of 2011 a biopsy had been done of the same area, but my new oncologist from Mayo in Scottsdale thought that since the latest CT's and PET were showing growth in density and size and had spiculation that the needle must have missed the nodule since it came back negative. The PET showed an increased avidity and hypermetabolic uptake with a peak SUV 2.8

I now have the results of that biopsy and hope you can help to understand the language and whether these conclusions will have a more positive or negative outcome from a decision I will have to make.

The lesion 1.3 cm was described as "well-differentiated adenocarcinoma with acinar and lepidic growth, invasive.
In the comments section it says "adenocarcinoma shows predominantly an acinar growth pattern.

I have consultations in 3 weeks with two specialists: a radiation oncologist and a thoracic surgeon.

Can you help me understand the terms used so that I may have an intelligent discussion of my case. If you have specific questions I should ask or any general advice I would appreciate it.

Louise Picco-Branney
P.S. I saw Dr. West in 2012

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Reply # - April 25, 2014, 07:25 PM

Dr West
Posts: 4735

The report says that there is an invasive cancer, which is often what correlates with a solid component on CT. It is common for there to be some elements of invasive disease along with some non-invasive/pre-invasive adenocarcinoma, which is what BAC is, and why it is now sometimes referred to as "adenocarcinoma in situ", or AIS.

It is standard to treat solid adenocarcinoma with surgery or possibly focal irradiation.

If you have other specific questions, please post them as a follow-up.

Good luck!

-Dr. West

Reply # - April 25, 2014, 08:12 PM

lmlb7665
Posts: 48

Thank you for quick reply. Since I am asymptomatic, and otherwise in good health, do you see an advantage of one procedure over the other. (That is radiation vs surgery)

Reply # - April 25, 2014, 08:35 PM

JimC
Posts: 2753

You would want to use the procedure that would be most likely to remove all of the cancer, but the choice would be based on a variety of factors, including the location of the tumor in relation to other body structures. Your own doctors would best be able to make the recommendation, after reviewing your scans and other medical information.

JimC
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Reply # - April 26, 2014, 06:58 AM

lmlb7665
Posts: 48

Thank you, Dr West and Jim. I am sure after my two consultations I will have more questions and will want to hear from some who have had the radiation and their experience with it. My thoracic oncologist at this time seems to think that either option would work for the lesion. By the way it is way in the upper right apex of the right lung.

Reply # - April 26, 2014, 10:44 AM

catdander
Posts:

Louise, I'm so sorry to hear your cancer has started to grow.
I know you don't or probably don't have what is known as a pancoast tumor but its defining trait is to grow at the apex of the lung and get involved in structures in and around the arm, shoulder, and/or spine, still while being a single primary curable situation. With any involvement of these structures surgery becomes risky and difficult. (after a surgery biopsy) My husband was treated with curative intent using radiation.
Of course I have no idea if any of that is close to your situation but I just wanted to share.

I wait for info from your 2 appointments. All the very best,
Janine

Reply # - April 26, 2014, 01:22 PM

lmlb7665
Posts: 48

Janine, thank you for your post. Pancoast was never mentioned and so I do not believe that is the case. In a few weeks I may be looking for some input on radiation therapy. And I welcome the comments from people who have had stereotactic radiation.

Reply # - April 26, 2014, 05:50 PM

catdander
Posts:

You're always welcome. D didn't have stereotactic but the norm. With stereotactic more radiation is use on a smaller more pointed area, you have to know exactly what you want to target.

Reply # - April 27, 2014, 05:46 AM

cards7up
Posts: 636

I had SRS on two tumors, one each in my upper and lower right lobes. I had no lymph node involvement.
Though this radiation is targeted, it still needs to go in and come back out. On the upper right, it hit my pectoral muscle, which is now scarred from radiation and causes me slight problems. I say slight because it's better than the alternative. Wishing you the best. Take care, Judy

Reply # - April 27, 2014, 06:53 AM

lmlb7665
Posts: 48

Good to know Dr West. Judy, were you given the option of surgery or radiation? If so, why did you choose radiation? It would seem so far, that either is going to be a viable option and the choice will be mine.

Reply # - April 27, 2014, 07:43 PM

cards7up
Posts: 636

I had two tumors and chose not to do surgery as it would be too involved. With my recurrence in only the bottom right lobe, I had surgery. Take care, Judy

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