Sarah, I'm sorry you have this worry hanging over you, and am going to provide a fairly long-winded reply which I hope will help.
Firstly with regard to the diagnosis. I think it's quite difficult for doctors to diagnose a lung metastases, because sometimes suspicious areas, can be scar tissue (particularly if a patient has had radiotherapy). For example, I have a suspected lung met, but they are not absolutely sure because it has remained solitary and the same size for quite a while (which is unusual). I am now on Capecitabine (an oral chemo), and they say if it shrinks then it is definitely a met, but if remains unchanged they will have to rethink. Your doctors could do a Pet scan, which gives the best view, but the only fullproof way of diagnosing a lung met is to do a biopsy - but that carries risks, and your doctors may be reluctant to do it.
Secondly, what I would say is that if you have a solitarysmall lung met, you might want to discuss the possibility of having Cyberknife Stereotactic Radiotherapy, which unlike conventional radiotherapy can be given at a curative dose, because it is so precise. Three NHS hospital have this machine (The Royal Marsden, Barts and Mount Vernon), and the Queen Elizabeth in Birmingham are on the point of getting it. Obviously,if you now have secondary cancer, it will not cure you, because other mets could pop up elsewhere, but it will sort out the lung met, and others may take a long time to get going. There is currently a problem getting funding for treatment (and I have a facebook petition which you may like to sign), but the Govt have just set up an emergency radiotherapy fund (similar to the emergency drugs fund), which is being adminstered jointly by the National Radiotherapy Implementation Group, and Cancer Research UK, and your doctor may be able to secure funding this way, if your PCT/commissioning group refuse to fund treatment. If you would like a bit more info about Cyberknife, please feel free to pm me, or go to a charity I have helped set up called
www.ukcknetwork.co.uk
Thirdly, with regard to whether the mastectomy or treatment of lung met should come first. I would say it depends on how fast the lung met is growing. The bottom line (sorry to be blunt), is that you have to breath to stay alive, and so if it looks like the lung met is going to be problematic, you will probably be well advised to get that under control first. Having said that the Prof that treats me say's there is very strong evidence that removal of the primary prolongs life (by as much as 50%), so removal should be on your list of to do's.
Again I'm sorry you may be joining us secondary peeps, but try not to think it's an immediate death sentence. The media portray cancer as either a curable disease, or a deadly killer that fells people in 5 minutes, and that is just not true. People with primary cancer do survive, but they can never claim to be cured, because cancer can return years later - and similarly a secondary diagnosis is not an immediate death sentence. There are many people on this forum, who have been living with secondaries for over ten years (even those with triple negative cancer). There are a huge range of treatments, and people on here will provide you with lots of information and support. So chin up chicken.
