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Breast Cancer

History: History of left breast cancer diagnosed in 2001 treated with chemotherapy and radiation therapy now with middle lobe pulmonary nodule positive for poorly differentiated non-small-cell carcinoma on 10/7/2009 percutaneous CT-guided core needle biopsy. This PET-CT is for breast cancer restaging and staging of lung cancer prior to consideration of therapy.

Impression:

  1. The 1.4 cm middle lobe pulmonary nodule is associated with abnormal glucose metabolism consistent with malignancy.
  2. No FDG PET or CT evidence for locoregional or distant metastatic disease. There is a 4 mm indeterminate pulmonary nodule in the right lower lobe which is most likely a noncalcified granuloma.
  3. Resolving right retroperitoneal hematoma.
  4. Incidental 2 cm left renal artery aneurysm.  Consultation with the interventional radiology service is suggested for any further needed characterization.
  5. Simple hepatic cysts.
  6. Prior granulomatous infection.
Clinical Utility:  Distant metastases from breast cancer are frequently found in the lungs, liver and bones. One advantage of whole torso PET imaging over conventional imaging modalities such as chest films, bone scanning, and abdominal ultrasound is its ability to detect metastasis at different sites and organs during a single examination. Whole torso PET imaging has high diagnostic accuracy for patients with suspected recurrent or metastatic breast carcinoma. (J Nucl Med, 1998 Mar; 39(3) 431-435.