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What Does This Chest Radiograph Indicate?
Question: My CXR showed basilair atelectasis lingula. Er physician mentioned nothing. I have HX Breast Cancer aggressive abd freq feel unable to fill my lungs and have left precordial pain heart is ok. Have had full bilt reconstuction and had Taxol , which had to be stopped 3 treatments early due to lung irritation 5 years back.
NED status post Triple Negative Breast Cancer Dx in April 2009 stage 2 grade 4 . Multifocal disease no nodal involvement as I discovered it 5 months after an US and mammogram showed negative results. It was rapid, bizarre and mixoid , poorly differentiated as per path report , negative receptors for ER, PR, and HER2 , second path requested reading showed a very low level of PR sensitivity. I was treated as Triple negative and underwent dose dense chemo Adriamycin, cytoxan for 12 weeks every 2 weeks, with Avavstin under clinical trial. Then underwent 8 out of ten weekly Taxol treatments , it was stopped due to lung irritation causing hospitilization and what the internal med student described as the beginnings og "ground Glass" . That was five years ago.
NED status post Triple Negative Breast Cancer Dx in April 2009 stage 2 grade 4 . Multifocal disease no nodal involvement as I discovered it 5 months after an US and mammogram showed negative results. It was rapid, bizarre and mixoid , poorly differentiated as per path report , negative receptors for ER, PR, and HER2 , second path requested reading showed a very low level of PR sensitivity. I was treated as Triple negative and underwent dose dense chemo Adriamycin, cytoxan for 12 weeks every 2 weeks, with Avavstin under clinical trial. Then underwent 8 out of ten weekly Taxol treatments , it was stopped due to lung irritation causing hospitilization and what the internal med student described as the beginnings og "ground Glass" . That was five years ago.
Brief Answer:
Doing pulmonary function tests might help to know lung capacity
Detailed Answer:
Hi XXXXXX,
Thanks for writing in to us.
I have read through your query in detail.
Concerning your heart, ejection fraction of 60 is good and the mild RBBB might remain insignificant.
Adriamycin is used in treatment of many kinds of cancers including breast cancers and I suppose you have been completely cured of your cancer.
The basilar atelectasis refers to mild collapse of the lingular and lower lobes of lungs. There are tiny air sacs in the lungs which might collapse to various degrees due to underlying problems. It can be due to obstructive causes and non obstructive causes. In your case the lung is only minimally collapsed. By itself partial basilar atelectasis is not a serious concern unless the lung volumes are grossly reduced.
I suggest you get your lung volumes tested by doing lung function tests, also called as spirometry. This will enable us to know if the basilar atelectasis has reduced your breathing capacity.
Paclitaxel (Taxol), used in the treatment of thoracic-based tumors such as breast and lung cancer is not known to cause significant pulmonary toxicity in most patients but rarely it can be a cause of lung irritation and fibrosis.
Though CT scan might provide detailed structural information about your lungs, the lung function tests are more important because you report shortness of breath on stress.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Doing pulmonary function tests might help to know lung capacity
Detailed Answer:
Hi XXXXXX,
Thanks for writing in to us.
I have read through your query in detail.
Concerning your heart, ejection fraction of 60 is good and the mild RBBB might remain insignificant.
Adriamycin is used in treatment of many kinds of cancers including breast cancers and I suppose you have been completely cured of your cancer.
The basilar atelectasis refers to mild collapse of the lingular and lower lobes of lungs. There are tiny air sacs in the lungs which might collapse to various degrees due to underlying problems. It can be due to obstructive causes and non obstructive causes. In your case the lung is only minimally collapsed. By itself partial basilar atelectasis is not a serious concern unless the lung volumes are grossly reduced.
I suggest you get your lung volumes tested by doing lung function tests, also called as spirometry. This will enable us to know if the basilar atelectasis has reduced your breathing capacity.
Paclitaxel (Taxol), used in the treatment of thoracic-based tumors such as breast and lung cancer is not known to cause significant pulmonary toxicity in most patients but rarely it can be a cause of lung irritation and fibrosis.
Though CT scan might provide detailed structural information about your lungs, the lung function tests are more important because you report shortness of breath on stress.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks great answer will do new PFTS . Question it's not a sign of lung mets is it?
Brief Answer:
No mention of lung nodules on X ray, hence no mets
Detailed Answer:
Hi XXXXXXX,
Thanks for writing back with an update.
Glad to know that you are considering PFTS to be repeated and hope the results are near normal.
As there is no mention of nodules or bone lesions, I will not think of mets. For peace of mind and if your doctor permits, doing a CT scan will be most informative. I have served in a cancer hospital for years and always compared with older X rays to look for suspicious nodules. Only in case of doubts and disagreements, further evaluation with CT scan was recommended.
Wishing you the best of health.
Regards,
Dr.Vivek
No mention of lung nodules on X ray, hence no mets
Detailed Answer:
Hi XXXXXXX,
Thanks for writing back with an update.
Glad to know that you are considering PFTS to be repeated and hope the results are near normal.
As there is no mention of nodules or bone lesions, I will not think of mets. For peace of mind and if your doctor permits, doing a CT scan will be most informative. I have served in a cancer hospital for years and always compared with older X rays to look for suspicious nodules. Only in case of doubts and disagreements, further evaluation with CT scan was recommended.
Wishing you the best of health.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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