When you going through the diagnostic process for breast cancer, you soon get acquainted with a host of medical machinery—mammograms, ultrasounds, maybe a breast MRI. If it turns out that you do have breast cancer, your doctor may order some more tests to see if the cancer has metastasized to other parts of your body. These tests may often be used in the years after your cancer treatment if you have symptoms that suggest spread of the cancer.
The test that the doctor chooses to use depends on the type of tissue involved and its location. I have recently gone through several of these follow-up tests because of some pain I’ve been having. In this article I’ll explain about CT scans, sometimes called CAT scans. CT stands for computed tomography, and CAT stands for computerized axial tomography, but they are the same thing. Most people just say “cat scan,” but I’ve noticed that my lab orders usually say CT.
A CT scan takes X-rays from different angles. Then a computer puts the pictures together so that the radiologist can see the body in three dimensions. One big advantage of a CT scan is that the radiologist can see slices of any suspicious area from more than one angle. The images can help the doctor determine the exact size and location of a tumor. Another advantage is that it can give good pictures of bones, soft tissues, and blood vessels in one test.
Here is what happened at my most recent chest CT. After I checked into the radiology department and put on a hospital gown, the nurse came to insert an IV line. For me, the most stressful part of medical procedures is usually the IV because I don’t have large veins, but this day, she got the IV in on one try. She took some blood to send to the lab to make sure that my body could handle the contrast solution or dye. In the past I’ve often had that lab test done in advance, but this time because of scheduling we did it the same day.
While we waited for the report, she asked questions about any allergies I had and what symptoms made the doctor order the scan.
Next we went next door to the actual CT room. The CT scanner is a large ring through which a small table passes. The technician had me lie down on the table and helped me get as comfortable as possible. Next she hooked up a tube for the contrast solution to my IV. She explained that she would take a set of pictures without contrast and then put the solution in for another set of pictures.
The actual test is easy. I lay there while the table began to move through the hole in the big ring. The machine made little whirring sounds and clicks while a voice told me when to hold my breath and when I could breathe again. Being still is an important part of the test because the pictures will be blurred if the patient moves. Although I am slightly claustrophobic, the CT scanner doesn’t bother me because it isn’t very deep. I can easily see through it, and at least part of my body is always outside it. Although the tech had to leave the room because of the X-rays, she assured me that she could see and hear me.
The machine works by sending X-rays from one side of the ring to the opposite side. As they pass through the patient’s body, they get pictures from many angles that will later be assembled for the radiologist to interpret.
After the first pass through the machine, which took only a few minutes, the technician came back and said she was going to start the contrast solution. She warned me that I might feel a warm tingling as it spread through my body. It was a strange sensation, but not painful. I went back through the machine, and the test was done.
She told me to drink lots of water to flush the contrast dye out of my body, and I was on my way after I double checked that the hospital knew which doctors needed to receive the report, and that I knew when I could expect to get the results.
Your experience could be different depending on the part of the body being scanned and the reason for the scan. You might not need contrast at all, or it might be administered as a drink or enema. If you have never had a test that uses a contrast solution, you will be monitored especially closely for allergic reactions to it. Be sure to tell the doctor about any allergic reactions you have had to other medications.
CT scans use more radiation than regular X-rays. If there is reason to suspect your cancer has spread, it is worth the risk of a radiation-induced cancer years from now to find a cancer that might kill you in the next year or two. However, because the risk is there, it is not wise to ask your doctor for more scans than you absolutely need.
Because radiation is involved, be sure to tell the doctor if there is any chance that you might be pregnant. There may be a way to get the same information with an alternate test.
Waiting for the results can be the hardest part of the process. It is usually at least two or three days because the radiologist has to read the images and write a report to your doctor. Then your doctor has to apply the radiologist’s interpretation to your symptoms and history to make decisions about what happens next. If holidays or weekends are involved, you might have to wait a week. I always call if I haven’t heard by the date the hospital told me when I had the test. Sometimes the report is just sitting there in someone’s in-box, and my call moves it to the top of the pile.
So far for me that report has usually been “A-OK, no tumor, no spread.” Sometimes it has been inconclusive, and then we move on to different tests to get a picture from a different perspective. I’ll write about some of those other tests in future articles.
Published On: January 28, 2012