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Thursday, December 24, 2009 JC asks

Q: How can I have Mets to Spine when Breast Cancer Stage IB only diagnosed July 2009?

I had surgery to remove Stage IB breast cancer (only 1 Sentinel Node involved) on Aug 31, 2009. I finished 4 rounds of Chemo Dec. 2.  However, it appears I broke my back-T11 and possible T10 on Nov 2 after a free "massage" for cancer patients. This happened when I got home and my back was in pain. As I usually do for back pain- (I've had it for 30 yrs or more), I lay down on the floor on my back. Something was terribly wrong! My spine was up off the floor, very different than usual!! I am thinking when she pulled my legs, she adjusted my spine counter to my scoliosis.  As I lay there, it CRACKED really loud and fell to the floor.  Upon getting up, I was in a lot of pain.  Regular X-rays showed nothing wrong.  I took Vicodin 10mg every 4 hours during the day for at least the first month.  It took them 6 wks to figure out I broke my back, meanwhile I'm walking around!!

At one point I sneezed violently one month after the break, and my back fell forward like on a hinge and I fell forward- luckily I was in front of my bed!!!  My Dr. ordered a Bone Scan, CT of my spine, and MRI.  The Radiologists had only the history of me having breast cancer.  Like I said, my back has been hurting me for 30 yrs.  They read the Bone Scan and MRI as Mets to the Bone.  However, the CT results showed a compression fracture.  I asked for one Radiologist to read all the reports with the history of chronic back problems in mind.  Two Radiologists read them and said what they saw is consistent with Bone Mets.  I have read that when Breast Cancer spreads, it usually goes to the bone first.  I'm so confused and frightened!!  If this is the case, how could it spread so quickly to my Spine?  I was told that my Breast Cancer was ER and slow growing.  I got my back brace fitted today to protect it from further fractures.  I had an appt scheduled with my Oncologist Dec 31.  He felt I should wait more than a week before I see him to find out the treatment plan!  Luckily the nurse got me an appt for this Monday.  It feels like I'm going crazy with grief and trying to be hopeful!!  It seems like if he felt there was something he could do to help me, he would have insisted I get in sooner that Dec 31!

   I had thought my next big hurdle would be to get through 7 weeks of Radiation to the Breast!  Now, I'm thinking this new development could kill me!!  I don't know if they are going to want to do surgery on my back.  I saw the MRI films and no tumor was seen. I'm going to ask that they refer me to UCSF which is a major Medical Center that treats Cancer and I've heard they are on the "cutting edge" with research.  Has anyone had a similar situation?  Thanks.

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Answers (2)
12/25/09 7:49am

Hi - My feeling is, with all of your back issues over the years, the radiologist could be mis-reading this. Is it possible to have bone mets with such a recent diagnosis? Yes, possible; not probable, but it seems just about anything can happen when you have cancer.

 

Your oncologist wouldn't wait till Dec. 31 to see you because he thinks he can't help you; that flies in the face of everything doctors are committed to doing, so please don't take the wait as a sign of anything other than holiday schedules.

 

I agree with you - get a second opinion. It sounds like there's anough uncertainty and disagreement here that it's warranted. The UCSF cancer center is one of the top ones in the country; read our list of Comprehensive Cancer Centers for others in California that fit this criteria.

 

Best of luck to you - hope you get some good news in San Francisco. PJH

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12/27/09 9:36pm

Thank you so much for your support! I was able to convince the nurse to get us in sooner to see the oncologist.  We have an appt tomorrow.  I am hoping he is ready for all my questions.  The orthopedic PA who reviewed my reports and asked 2 different radiologists to also review them left messages for my Dr. which were not as of yet returned before the holiday.  The wheels turn awfully slowly around here.  I fractured my vertebrae on Nov 2, and it wasn't until a few days ago (Dec 24) that it was finally addressed by putting me in a brace.  If this had been done sooner, I would be a lot farther on in having it heal!  I don't know how these things work, but I sure don't want by broken back to delay my cancer treatment!!  JC  

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12/27/09 10:05pm

Luckily, I wouldn't see any reason why your broken back would delay your cancer treatment... but then, I'm not a doctor. I'm so sorry you're having to deal with these two issues at the same time - one would be plenty!! I hope you have a good appointment tomorrow, and come away with all your quesiotns answered. Keep in touch, OK? We're here for you - PJH

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12/26/09 3:35pm

JC, if it turns out that these are bone mets, it is very possible that they were there all along and missed because they were too small to show up on original staging tests.  I have a friend in your situation, and that's what her docs think happened.  That was ten years ago.  Once they realized she had bone mets, they modified her treatment plan, and she is doing fine now.  With your history of other back problems, being sure of the diagnosis will be important in coming up with the best treatment plan.  This all sounds terribly painful, no matter what the cause.  I hope your next appointment gives you some good news and pain relief.

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12/27/09 10:00pm

I appreciate so very much your encouraging story of your friend who is doing fine after 10 years!!!! 

  When they discovered I had breast cancer, the only testing done was in regard to the breast cancer- (tests on the biopsy and cancer removed during surgery, including the one positive Sentinel node and negative nodes under the arm).  I don't know about any original staging tests!!  They didn't even do a chest x-ray--which, being a nurse, I know used to be routine before surgery!

  The CT scan of my chest, abdomen & pelvis which was done in an attempt to diagnose my back pain showed 3 small areas in my lung!  The radiologist described them as 1.) a nodule 0.2cm,  2.) a square shaped 0.5cm opacity (may be focal pleural thickening)  3.) small area of atelectasis of left base. He recommends a 3 month follow-up chest x-ray, as they have no other studies to use for comparison! This makes me wonder if these areas could also be cancer! 

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