Scans?//

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Hi, this might be a silly question. I have sort of tried to discuss at the hospital but the answer I get is statistics.!!
Mid March I was diagnosed with ERpositive and her2 negative Breast cancer which had also gone to the lymph nodes. 3rd April I had lumpectomy and axillary node clearance surgery and now awaiting chemotherapy due to start on the 28th of this month followed by radiotherapy.

My question is how do they know it’s primary breast cancer? Why do they not check everything else? Why is a MRI or CT scan of the body not offered.

When I have mentioned this to the oncologist the reply was that they use the PREDICT algorithm and statistics show that women with my type of breast cancer and my age would have a clear scan therefore it is not requested. I am petrified that this thing might be somewhere else in my body however I do know that the chemotherapy would kill the cancer cells if they are elsewhere but I keep having nightmares that there might be a tumour requiring surgery elsewhere in my body. I am very positive about my diagnosis and upcoming treatment. It’s just this little voice in my head which is making me doubt the process.
Thank you for allowing me to air my concerns and attempt to get them out of my head in this way
thank you xx

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I think in the end it is all about money. They only offer scans at this stage if the chances of there being metastasis are high or if there are symptoms, as these tests are expensive. I wasn’t going to have one, but as they found a much much bigger tumour during surgery and a few affected nodes, I was rushed to a PET scan. It means I was (and still am) very high risk.

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Hi keepupfiona

Thanks for your post asking about how your treatment team know you have primary breast cancer and why is an MRI or CT scan of the body is not offered to check elsewhere.

It is understandable that you are petrified the cancer may be somewhere else in your body. Any scans to check for this, including CT and MRI scans, will depend on someone’s individual situation and are not always necessary. Your doctor will have based this decision on a number of factors, including the number of lymph nodes and other risk factors about your breast cancer, as well as whether you have any symptoms. The Predict tool may also be used, as you have mentioned. This tool can help doctors decide what the benefit of further treatment might be after surgery, based on your risk of the breast cancer coming back (recurrence). Your doctor will use this information, to work out the likelihood of cancer cells being elsewhere.

Doctors will consider if having a scan will change the treatment offered. If having a scan is not likely to change the treatment plan, they will want to start treatment instead. The aim of the chemotherapy after surgery for primary breast cancer is to destroy any cancer cells that may be present and reduce the risk of recurrence

You also mention that you are ER (oestrogen) positive which means you are also likely to be offered hormone therapy. This treatment also aims to prevent a recurrence anywhere in the body. Radiotherapy aims treats the remaining breast tissue in the breast you have had surgery to.

It is very normal to have concerns. We offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which you may be interested in. They include face to face and online courses and events.

For more details about all of these services, please see the information on the link, or call our free helpline.

Do also call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to additional support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks.

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Best wishes

Teresa

Breast Care Nurse

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