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>>>Dr. Harness: There are multiple tests that we do on patients with breast cancer and one
of the questions that comes up not at all infrequently is a question, “what are the
indications for PET CT examination in breast cancer patients?” There two different sort
of times that such testing would be indicated. One is, at the time of initial diagnosis and
another is as part of a routine followup of patients who are known to be stage II or stage
III originally; and I suppose then also, in stage IV patients PET CT could be used as
a way of monitoring how they are doing with their treatment for their stage IV disease.
Now, I am going to give you the surgeon’s view of this right now and then I am going
to allow one of my medical oncology colleagues to give you, sort of the view that the medical
oncologist has, particularly those who are using PET CT as part of the routine followup
process.
In patients who present with positive lymph nodes at the time of diagnosis and we generally
establish that not only with an ultrasound examination but we want tissue so performing
an ultrasound-guided core biopsy would be an important way of establishing that the
lymph nodes in the axillary region are positive. So that is usually part of the initial workup.
The suspicion for that if not already there may come out of a breast MRI examination or
certainly from the physical examination of the axillary.
There are multiple indications for why we would do the biopsy, and if it is positive,
my view as a full-time breast surgeon is that a PET CT is indicated as part of the initial
workup.
In other words, if we already know somebody who is stage 2, then are we concerned that
they can be stage IV which is the value of the PET CT examination. A lot of the same
thing can also be said at the initial diagnosis for the patients who are at stage III. Now,
in general stage III are larger breast cancers, 5 cm in size or greater and/or coupled with
several lymph nodes that are positive, and the answer is the same. It is the same for
their locally advanced breast cancer patient. Fortunately, rarely do we see true inflammatory
breast cancer, but I am confident that my medical oncology colleagues would say that
with an initial diagnosis of inflammatory breast cancer, that a PET CT examination would
be indicated.
So, hopefully that sort of wraps my views as a breast surgeon about the use of PET CT
examination of the chest, abdomen, and pelvis. I am involved with that generally on the front-end
or occasionally if I have worries or concerns that the patient is progressing their disease
and they have not actually seen their medical oncologist for followup.
Hi, I am Dr. Jay Harness and I want to share with you an important information that I believe
*****
that every newly diagnosed patient with breast cancer needs to know.
Susan Denver: “I am a breast cancer survivor.”
Katherine Stockton: “I am a breast cancer survivor.”
Coree: “I am a breast cancer survivor…”
Susan Denver: “…and I want every woman to know…”
Katherine Stockton: “…about personalized breast cancer treatment…”
Susan Denver: “…and the Genomic Test.”
Coree: “A test that helps guide a woman and her doctor…”
Katherine Stockton: “…to the best treatment options for her.”
Susan Denver: “Pass it on!”