Inconclusive Lung Biopsy on Suspected Recurrent Lung Cancer - 1267402

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sonshine
Inconclusive Lung Biopsy on Suspected Recurrent Lung Cancer - 1267402

My 73 year old Mom had part of her lung removed in 2012 due to lung cancer (life-time smoker). She had a CT Scan in October and the report read...
"Comparison is made to study of04/04/2014. There has been enlargement in the irregular of the soft tissue density, consolidation in the lateral left chest. One component is new and measures 28 x 20 mm. Another component has changed in size is less pleural based, but is more intraparenchymal measuring 16 x 26 mm. There are a couple of subtle noncalcified nodules in right lung. There is no pleural effusion. There is volume status post thoracotomy of the left lung. There is mediastinal shift to the left. The heart is not enlarged. There is coronary artery calcification. There is no mediastinal or hilar adenopathy. IMPRESSION : There is a soft tissue density mass in the left base that is increasing in size as compared to the previous study. I see no adenopathy."

10/31/14 Pet Scan - In the left costophrenic angle and apparently involving the hemidiaphragm is an ill-defined soft tissue density with a standard uptake value (SUV) of 4. Above that a nodule against the pleura on the lateral aspect of the left lower lung shows an SUV of 1.7.

11/26/14: She had a biopsy of this "new component" last week that they are calling inconclusive. Could be inflamation, could be this or that. This doctor suggested that she WAIT 6 months and then have another CT scan.

To me - when dealing with an older person that has already had lung cancer - isn't 6 months way to long to just "wait and see"? Should we just do another biopsy?

Please help -

JimC
Hi sonshine,

Hi sonshine,

Welcome to GRACE. These scans detail a complicated set of circumstances, and detailed interpretation of scans is beyond the scope of what GRACE offers. In addition to the legal issues involved in giving specific advice to a person who is not a patient of the GRACE faculty, we would be proceeding on the basis of very limited information, with no opportunity to actually view and compare scans, examine the patient or review her overall medical record.

That being said, there is no reason that you can't advocate for a scan interval shorter than six months. Oncologists vary in their opinions on scan frequency, so your mom's oncologist may be willing to be flexible.

A repeat biopsy is not without risk, and may also fail to resolve the issue.

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

Dr West
We really aren't in a

We really aren't in a position to second guess someone with direct access to the details of a patient's case, but I think either advocating directly for a shorter interval if you're concerned that the interval is too long, or else seeking a second opinion from someone else who can review all of the information, would be appropriate courses of action.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education