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This question was answered on Thu 19, Jun 2008 01:55am by Dr Paul S, MD

Pleomorphic invasive lobular breast cancer--questions about incidental findings on staging scans


    
Asked by san (Female; 38; 2.7 cm pleomorphic invasive lobular breast cancer, ER/PR +, HER2 -, grade 2, stage IIa (negative nodes); Relevant drugs:CAFx6 37 radiation treatments tamoxifen ) on Tue 17, Jun 2008 09:50pm

On my staging scans, there were two incidental findings: 1) a 2mm cyst on the liver and 2) diverticulosis of the sigmoid colon. I have two questions. One, I was told that the liver cyst was indeed a cyst because it only showed up on the CT done with contrast, but not on a subsequent PET/CT done without contrast. Is this true, or should I ask for an abdominal u/s to verify the cyst is just a cyst? Two, I know that diverticulosis of the sigmoid colon is very common. However, it does not seem that it would be common in a 38 year old who eats a lot of fruits, vegetables and whole grains. What would a differential diagnosis of diverticulosis be? My concern is that lobular cancer tends to spread to the gastointestinal area and is hard to see on scans, and I wanted to know if lobular mets could mimic diverticulosis. Thank you in advance.

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Answer by Dr Paul S, MD  on Thu 19, Jun 2008 01:55am:

The negative PET Scans is enough evidence to rule out the presence of metastases both to the liver and the sigmoid colon area. The divertucolosis may indeed be present even if your background of a high fiber diet. Diverticulosis development may only be minimized by a high fiber diet but not at all preventive. An ultrasound is not likely to be of benefit given the already negative PET scans (which makes metastatic cancer diagnosis unlikely). Continue with the regular surveillance visits with your doctors and not worry too much about these present incidental findings. Regards and God bless.

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