Dr. West or other oncologist:
I am a 60 yo, post-14 yr stage 2 breast cancer patient. I went to my oncologist in March with a complaint of an off and on burning sensation across the front of my chest and down BOTH arms (feeling like a bad sunburn). All of this has since resolved, except now I have a small area in my thoracic spine that when pressed on, presents a slight burning pain.
Resulting thoracic and lumbar MRIs showed several degenerative changes, but no obvious neurological cause for my thoracic burning. However, the MRIs did show several spinal lesions ranging in size from 4mm to 9mm. They are round lesions with smooth margins. There are several in my thoracic spine, one on L4, and one on my sacrum.
A PET scan detected ONLY the L4 lesion (3.2 SUV) and one on my sternum (1.7). Both are subcentimeter in size. The sternum spot was biopsied in June by an interventional radiologist because it was the easiest and least risky to access. It turned out to be a NON-CASEATING GRANULOMA.
Would you hold off on treatment and keep doing follow up PET scans and MRIs until one lesion grew large enough to be safely biopsied?
And IN GENERAL TERMS, what is the MINIMUM size of a SPINAL lesion you would consider biopsying? Would you be comfortable biopsying a spinal lesion of, say, 1 cm? Some of my vertebral lesions are posterior and the one in L4 is anterior.
Thank you so much!