CT and Lung Nodules

Hi to all, hope it's ok to post here rather than starting my own thread.

Back in June, I was hospitalized for what ultimately was treated as pneumonia (they tested for a zillion things). I had a CT of my lungs at that time, and they commented that there were small nodules that should be closely followed given my history as a 2x BC survivor. It made me greatly worried to read this, but nobody seemed very concerned at the time, including my MO. The primary focus was to finish chemo. Now that's done (yay) and I'll be moving towards radiation next, but the 3-month follow up CT is happening in early Sept and the anxiety is starting to creep back in.

What the heck is a nodule anyway? Do they come and go (any chance they were present just because of the infection)? Is there a size at which they start to suspect cancer (mine were characterized as scattered up to 5mm)? What questions should I be asking my team at this point?

I'm low-key terrified. But I'd rather understand what I'm possibly facing and deal with it than consulting Dr. Google. Thanks for any information you can provide.

Oh and again, if it's better to post in a new thread or someplace else please let me know!

@maggie15 thank you so much for this!!

I have existing heart damage from my first time around so my RO plans to try a few different positions during simulation. Hopefully such positioning spares the lungs too, but there's always scatter so is not zero risk.

I would have had no idea about the pneumonia and radiation damage risk -- sorry you went through what you did and I appreciate you sharing the 'lesson learned.' I'll definitely make sure RO knows all about the CT and my infection, I haven't seen her since January. Fortunately she's a whole-person kind of clinician.

Longer-term, yes, more scans = more anxiety. On the other hand, I've done heavy BC and GynC surveillance since my first dx 14 years ago. (Oh, and pancreatic cancer screenings, BRCA 1+ is so fun!) Hopefully once I get more comfortable with all this lung nodule stuff I can mentally put it in the same place as I do all the other surveillance.

I can't tell you how helpful your reply has been to me. Thanks! I'll update this group after the CT on 9/5.

Hi bookworm, I’m so sorry that you ended out with sciatica. It’s terribly painful and really limits your movement. I hope the nurses are more careful with the Faslodex injections. Hopefully Metformin keeps your glucose levels in check. When I was taking long term oral steroids for RIPF I eventually had to go to insulin injections. It seems that every med has SEs requiring more meds. It’s all worth it if the Itovebi is keeping things stable.

Just got back from a visit with a neurosurgeon who was all set to operate on my cervical spine until he examined my limp right hand. He thinks the problem might be brachial neuritis caused by my long term bout of statin induced liver injury and lingering damage from rads. He ordered an EMG and referred me to a neurologist. I guess the cure is 3 to 8 years of PT. By that time I’ll be a functional lefty. There are so many weird diseases out there.

I hope Marge and kks have good scans this month and you, Cindy and I have the same in October.

Enjoy your son’s football games and some cooler weather.

Hi Marge,

Yay for the good mammogram and shrinking fat necrosis. Hopefully you’ll get the CT results soon, The radiologists are probably on vacation which would slow down releasing results, lol. Keep us posted.

Hi kks,

Great news on the CT results. Your MO will order any further surveillance scans as needed.

Good luck with radiation. If you develop a cough let the doctors know right away since pneumonitis which is a possible side effect can be treated effectively early on. Fatigue is a common SE as you probably remember. My hospital offered free acupuncture for those in active treatment. It really helped so I paid for a course of acupuncture after I had finished. Calendula ointment worked well for my skin redness and irritation. Most facilities have a recommended skin protocol.

I hope it all goes well.

Marge, It’s too bad you have to wait for your doctor’s appointment to get your CT results. My pulmo usually has something to add but It’s nice to know what the radiologist reported in advance. I hope you get good news.

Yesterday I had an appointment with a neurologist where ambient listening technology was used. AI is used to transcribe and analyze what is said to come up with notes. The appointment included a complete neurological exam with tons of measurements which were recorded in tables. One relevant factor wasn’t mentioned but compared to all the cut and paste notes that usually show up in after visit summaries it was much more accurate. I also got a portal message with a short visit summary, plan, differential diagnoses and next steps. I was skeptical about the use of AI but this seems to be an improvement.

Maggie I am glad you got testing done. I tring to understand that the AI read the test or interpret what the radiologist said.

I finally got my CT in the portal. I see Dr wed.
here is what it said.
CHEST: Negative for discrete axillary, hilar or mediastinal lymphadenopathy or

mass. Right IJ port catheter is in place. Negative for pleural or pericardial

effusion. There is interval decrease in centrally calcified granuloma in the

right middle lobe. Lungs otherwise clear. Negative for acute infiltrates.

ABDOMEN PELVIS: There is mild hepatic steatosis. Liver and spleen otherwise

unremarkable. Negative for adrenal mass. Kidneys unremarkable. Pancreas is

within normal limits. Bowel in the abdomen and pelvis normal in caliber.

Negative for discrete fluid collections. Negative for lymphadenopathy. Appendix normal

It doesn’t talk about my nodule. Should I have my dr go back and ask about it or is it not there any more.

Hello all. I'm back on here from 2016/17 when I was trying to make decision on whether to do BMX after 10 yrs of Letrozole (dx 9/2005) bc originally I only had a rt lumpectomy. I was also trying to figure out how to get more screening when all I could get was mammo and I have medium dense breasts. That was probably the big thing then . I have asthma and have had some lung issues in past w I believe calcified nodules and also ascites ( scarring) at bottom of lungs. I did go for a ct and was cleared . This was about 2017 or 18 at latest. Anyway asthma Dr said I could wait to do lung X-ray (and possible ct ) for a year the last time I saw her which was mid 2023 I think. Well my asthma has been ok but wondering should I be going back to pulmonologist. I was originally sent there bc of chest x-ray around 2016 ordered by allergist to just be sure. Idk I can go back to my allergist or the pulmonologist or both. I've been doing okay w asthma for most part . I know I at least prob need to see asthma allergy specialist and they'll have me to do the chest x-ray , I'm pretty sure and could go from there. I lost my husband two yrs ago and my sister we ho is one yr younger 4 months ago so I guess I've dropped the ball on the allergies/ asthma and idk maybe the pulmonologist too. I do see my oncologist about twice a yr. but sometimes it's off a couple months. I getammograns and recently have been allowed to get MRI breast on my since my husband passed. Also a question is my MO wants to dismiss me and have me go to my PC Dr after this next check up if ok . I'm scared . I know I won't get the twice a year nanno MRI I've just recently been getting. Any advice? Good luck and hugs to all of you. My mom had this years ago so it's just tough.

Maggie you are right I was. Worried about my liver I guess it’s has went to mild and I think your right that interval decrease in centrally calcified granuloma is the lung nodule we been watching. I will ask tomorrow.

Marge, I’m glad the smaller granuloma was the nodule of concern. From what I have read the monarchE trial showed that two years of verzenio continues to provide good protection even after it is stopped. You’ll still be taking tamoxifen and your MO will continue to monitor you. Long term use of verzenio is more likely to cause side effects like blood clots, ILD and liver problems. I’m dealing with those lung problems from rads and high liver enzymes from a statin. The malfunctioning liver caused a rare neurological syndrome so my right hand and arm is numb and won’t work; hopefully another year or two of PT will bring it back per my neurologist.

It must feel like your security blanket has been taken away but I wouldn’t wish SEs like these on anyone. Breast cancer upends our previous lives. Ask your MO for a referral to a counselor who can help you talk through your fears which are real. Hugs for you.

I’m doing good. I go in Thursday for thyroid ultrasound, to check in nodules. With a follow up with the endocrinologist immediately following that.

Lung nodules are stable. I don’t go back to the Thorasic surgeon until May of 2026. CT prior to that appointment.

Hope we’re all hanging in!

My chest CT showed consolidation in my right lung so my pulmo prescribed a steroid pack. I haven’t noticed any decline in my breathing and today my PCP couldn’t hear any crackles in my lungs so I’m hoping it will go away. The nodules in my left lung were pretty much the same.

My ultrasound showed that the thyroid nodule got smaller from the radiofrequency ablation, 33% by my calculations. I don’t see the thyroid surgeon until December but I think she’ll be pleased.

Next up is a lumbar puncture on Thursday. Happy Halloween!

Hi @kks_11, It's hard to know who is actually going to follow you. My hospital works on the team approach and from what I've seen they divide the workload without any real pattern, My surgeon's NP schedules my mammograms and sees me afterwards. I had been seeing a medical oncology NP until a tumor showed up in my hip and I was transferred to my MO. I've seen my RO by default a few times (he sent me to the ED when he saw my right arm.) If whomever you are seeing can't answer your questions make sure they bring in someone who can.

The lumbar puncture is part of the neuro workup. Within the past couple of months my left fingers and all toes have gone numb and my calf muscles have pins and needles. My PCP is picking the differential diagnosis of paraneoplastic syndrome (an autoimmune reaction to cancer cells.) I have gone along with the hope that the indeterminate tumor is probably benign since there is a high chance a biopsy would break break my hip but I might have to re-evaluate. Two diagnoses have been shot down so who knows what is going on.

Health insurance for next year seems to be problematical for almost everyone. My Medicare part D plan company has exited the state along with several other insurance companies. None of the seven plans left have all my meds on their formulary. Hopefully my resourceful pulmo can help with my inhaler since the $7000 it costs won't count toward my out-of-pocket limit. I hope you can get as much as possible done before the end of the year and you end up seeing a helpful provider.

Maggie, before I went on Medicare (especially Part D) I was OOP $70 per albuterol inhaler. Whenever I traveled to Europe, I bought as many Ventolin inhalers (OTC in the EU) and 2% Voltaren (also OTC; only the 1% is available OTC here) as I could afford. The inhalers were about 7Euros each. Fortunately, Customs didn't flag my luggage for inspection. My Humana Part D plan lets me buy them for $20 apiece. My asthma has been so well-controlled on Singulair that I rarely use a rescue inhaler (maybe once or twice a year during allergy season or a chest cold) so I have quite a backlog (some will likely expire before I use them). I do carry one in my purse and keep one in every room I frequent.

My husband & I have had small lung nodules detected on CT scans (his after a bowel repair and mine routinely along with abdomen MRI to follow up my ocular melanoma dx). Both of ours were directly connected to coughing jags—his during mycoplasma ("walking") pneumonia and mine in 2019 when I had parapertussis and coughed like crazy for 3 weeks. His have disappeared; mine are stable. Radiologist said they are scars.