I had a post-chemo/pre-op mammogram and ultrasound. This is mostly to ensure there is no new cancer (not likely since my oncologist and I could both feel the tumors shrinking), and to measure the mass that’s left so that the surgeon knows what to look for where.
It occurred to me to go back and look at the posts I had made when I first had these tests done. I was surprised and a little disheartened to see that I’d never documented the results of the scans before. So now, the sizes of the tumor and lymph nodes are included below because I’m talking about a decrease in size of each.
The results of the mammogram back in October were that I had a 46 x 37 x 39 mm lobulated high density mass with spiculated margins and occasional coarse calcifications. What does all that mean? When cancer grows, it’s not a nice, smooth piece of tissue like the rest of the cells in our bodies. Women’s breasts normally develop extra spots of calcium deposits as we age. They aren’t necessarily an indicator for cancer, nor do they increase your risk for getting breast cancer. What makes these calcifications different is their size, shape, and how they show up in the breast. In my case, they were large irregular, rod or V shaped, calcifications that followed the path of the milk duct. Well, that and it was already almost 2 inches across and about 1-1/2 inches around. Interestingly enough, each scan type comes up with a different measurement for the tumor. They differ only by a couple of mm, but still interesting how each “sees” the tumor.
The mammogram part of this was a little stressful. When I thought I was done and going to be called back for the ultrasound, the mammogram technician came back out and wanted me to come back in for another scan. They found some new calcifications, and we needed to prove that they weren’t cancerous. Talk about freaking someone out. All the things you’d expect went through my mind while I was back out in the waiting room a 2nd time. Was the chemo a waste of time? How can I have new cancer? What do I want to do about it? After the 3rd scan, the radiologist came in and confirmed that what they were seeing were what are called skin calcifications, which are benign and nothing to worry about. My breast tumor now measures 42 x 22 x 22 mm, which is about a 10 mm or just less than a 1/2″ decrease in size, which is about a key lime rather than a large plum.
The Ultrasound originally showed my breast mass at 39 x 21 x 31 mm, and three affected lymph nodes, the largest with a 29 mm diameter, which is roughly the size of a walnut. A normal lymph node in the arm pit is usually about smaller than 1/4″ around. My largest lymph node also shrunk and is measuring 13 x 24 x 13 mm. It’s more oval in shape, so at its length is about an inch and it’s got a circumference of about 1/2″. So it’s about the size and shape of a grape.
The original MRI, done in November, showed the breast mass to be approximately 43 x 52 x 32 mm, so a little bigger than the mammogram. There was no extension to the chest wall, skin, or nipple areolar complex, which means that it’s not spread further than the milk duct. There was also no evidence of multifocal or multicentric disease, which means that it’s a single tumor, not multiple ones bunched together.
The new MRI shows an irregular mass with spiculated margins and rim enhancement has decreased in size. It now measures approximately 36 x 21 x 15 mm in diameter, as compared to 52 x 43 x 32 mm on the prior exam. Axillary lymph nodes: The previously biopsied lymph node with a marker clip has dramatically decreased in size, now measuring approximately 6 mm in maximum diameter. However, at least one residual abnormal axillary node is evident. It measures 4 mm in maximum diameter. The deeper nodes, evident on the CT of 11/8/2018 and the CT PET of 11/14/2017 are not included on this exam. This means that the deeper nodes are no longer enlarged or showing signs of cancer.
The November CT scan showed Lobular enhancing mass (breast tumor): 38 x 33 mm in with a 10 mm subpectoral lymph node and largest axillary node measuring 22 mm. See what I mean about different sizes? The CT sees the breast tumor about the same as the ultrasound, but sees the lymph node more like the MRI.
My latest CT finds decreases in the sizes of the tumor and lymph nodes as well, along with no new or advancing metastasis or adenopathy. There was a decrease in size of the right breast mass 26 x 16 mm, which was previously 37 x 28 mm.There is one lymph node that has not “resolved,” and it measures 15 x 15 mm when it was previously 17 x 13 mm.
In other words, for all 3 of these scans, chemotherapy did what it was supposed to do, which was to kill the cancer and shrink the tumors.