Wednesday, June 30, 2010

PET/CT SCAN 6-30-10


Findings: There is widespread hypermetabolic osseous metastatic disease with associated osteoblastic changes which are most prominent in the spine and pelvis.  Since the previous study there has been an increase in hypermetabolic activity in metastases in the sternum, the scapulae, the thoracic spine, the lumbar spine, the sacrum, bilateral ribs, the femurs and the iliac bones.  Peak SUV values in a lesion in the left iliac bone now measure up to 10.4 compared to a 6.6 on the previous study (4-8-10).  Many of the lesions previously seen in the pelvis appear to have a larger hypermetabolic component than previously seen.  There are no areas of soft tissue metastatic disease in the neck.

No pulmonary lesions are seen.  There is no adenopathy in the neck or chest.  There is no evidence of metastatic disease in the liver, spleen, pancreas, adrenal glands or kidneys.  No adenopathy is seen in the abdomen or pelvis.  There is hypermetabolic soft tissue density in the right side of the pelvis measuring 37 X 52 mm with SUV values of 12.6.  This has an appearance suggesting an enlarged right ovary.  The metabolic activity in the right ovary is significantly greater than left ovary where there are peak SUV values of 5.0.  The right ovarian metabolic activity is nonspecific and may be related to a physiological activity.  However, the possibility of ovarian metastatic disease cannot be excluded.  Metabolic activity in the left ovary is in the physiological range.

Previous Study: 4-8-10

Tuesday, June 1, 2010

Genetic Testing Results


Clinical Interpretation: This testing detects approximately 90% of individuals with inherited breast cancer. We are unable to estimate her remaining chance for carrying an undetectable mutation in a different gene due to her small paternal family structure..

It is highly unlikely that her sister or brother would have a detectable mutation

Application to Ms. Comeau-Nguyen: We still do not know the reason for her early onset breast cancer or the family history of breast cancer. At this time genetic testing has been unable to find an inherited cause of her breast cancer.

Application to her siblings: Her sisters and nieces would be considered to have an increased empirical risk for breast cancer based on this family history. They should meet with their care providers to discuss screening.

Should new genetic testing become available that would apply to her history, I will contact her as long as we have current contact information. Ms. Comeau-Nguyen should keep this report in a safe place and Penrose Hospital will keep a copy for a maximum of ten years. Should anyone else in the family develop cancer, she should contact me so we can determine if it would alter the family's risk analysis or indicate different genetic testing.