化療一年後PET SCAN跟進

醫生你好。母親65歲，2019年10月確診三陰性乳癌，12月切除右邊腋下淋巴及全個右邊乳房。2020年2月起開始化療至5月底中斷（打了四針紅針及一針紫杉醇，5月底因感染入ICU後醫生指不適宜繼續化療。其後在8月-9月電療。之後持續跟進。

以下為剛於2022年6月做的PET SCAN報告，請問有否異常？謝謝﹗

Procedure: WB Breast Ca FDG
Pharmaceutica l: F18-fluorodeoxyglucose 11.91 mCi
Clinical information (from referring clinician):
triple negative breast cancer in remission. PE ICT done as FU. last PET in 11/2020 noted mildly
hpermetabolic GGO at anterior Rt lung ? post RT changes

Diagnosis (from referring clinician):
ca breast

Report:
F18-FDG ONCOLOGY PETICT SCAN REPORT

PROCEDURE
Patient fasting
F18-FDG was then injected intravenously.
PET imaging from head to upper thigh was taken after 60 minutes.
Plain CT for attenuation correction and localization.

PET/CT FINDINGS
Blood glucose level 5.5 mmol/l at the time of FDG injection.
Comparison with prior study dated 25-11-2020.

No gross hypermetabolic brain mass. The ventricles are not dilated. No midline shift.
(Please note that FDG PET is not sensitive in detecting small brain lesions.)
NP, tonsils, para-nasal sinuses and larynx are unremarkable.
Hypermetabolic left upper jugular node (SUVmax 7.5, 5mm) can represent reactive
lymphadenopathy, less likely DDx metastatic node.
No hypermetabolic enlarged SCF node.

Status post right modified radical mastectomy with mild FDG activity over right anterior chest wall
and axilla probably due to post-treatment changes.

No gross FDG-avid left breast mass seen.

Similar small left axillary nodes with mild FDG activity (6mm, SUVmax 1.7), likely reactive in nature.

Concerned mildly hypermetabolic streaky opacity at right lung apex is stable in appearance and
uptake (ım92, 18mm, SUVmax 1.7; previous 20mm, SUVmax 2.1).

Mildly hypermetabolic ground glass opacities at sudpleural anterior right lung are seen, likely due to
post-RT changes

Mild bronchiectasis over medial RML noted.

No enlarged hypermetabolic mediastinal lymphadenopathy.
No pleura or pericardial effusion.

No hypermetabolic mass over adrenals, liver, spleen, pancreas and kidneys.
Gallstone noted.
No enlarged hypermetabolic lymphadenopathy seen in abdomen and pelvis.
The bowel uptake is unremarkable.
No abnormal FDG focus over uterus.
No ascites.

No hypermetabolic bone secondary is seen within the scanning range.
A small mildly FDG avid subcutaneous nodule at left proximal arm (SUVmax 1.6, 2mm, Im 69) is
non-specific, may represent inflammatory nodule.

(Lymph nodes are measured in short axis.)

IMPRESSION:
1. Status post right modified radical mastectomy. No gross hypermetabolic right chest wall mass to
suggest local recurrence.
2. Concerned streaky opacity at right lung apex with non-specific mild FDG activity is stable in
morphological appearance and FDG uptake
3. Hypermetabolic left upper jugular node can represent reactive lymphadenopathy, less likely DDx
metastatic node.

潘智文醫生回覆:
6/14/2021

單憑正電子掃描報告來判斷，並沒又復發的跡象，但這不能作準，因為醫生一定要同步看影像才能作最終的建議

以上資料只供參考，不能作診症用途，
請與家庭醫生查詢並作出適合治療。
如有身體不適請即求診，切勿延誤治療。
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