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Lump on surface of sternum

EB303
Posts: 22
Joined: Sep 2017

It's been a while since I popped onto the board. My wife is set for her 1 year (post chemo) scan this week. She has 6 cycles of ABVD that ended April 16th of last year (The Bleo was only for 3 cycles.) After her third cycle she had interim scans that came back clear. She was stage 2 with 3 enlarged nodes in her pelvis / upper leg. Only B symtpon was a rash on her legs (which went away after second cycle).  Since her last treatment she has felt fine, no B symptoms etc.  We would be feeling confident except a couple weeks ago, she felt a lump in the center of her chest, besically lower sternum / xiphiod process. At first, it felt like a softer little nodule and to me the location was right below the sternum (ie could be the xiphiod). However last week it was more on her sternum - a little higher up. I had a hard time feeling it but she said she could.

I've been reading that tumors that develoiped on the sternum, by most accounts, were on the inside - meaning likely not felt from the outside - they were internal (if that makes sense). We'll have at least some answers soon but I was wondering if anyone has dealt with medinastal (sorry if I'm spelling wrong) and if they could feel it at the surface.

She just had her bloodwork taken yesterday and thanks to MSK's amazing service, we got the results back on their app. All numbers were normal - in fact over the past year (taken quarterly) some levels were elevated but trending down to normal each time. Are we panicing for nothing?

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3257
Joined: May 2012

I do not recall the particulars of your wife's case, but since she just did 12 infusions (six cycles) of ABVD, she undoubtedly had some form of advanced Classical Hodgkin's.

Generally, relapse so fast for any HL is very uncommon.  You are reading way too much into "where the node was felt", etc. There are generalities regarding how or where a lymphoma first presents, but this just that -- a generality.  All have a thousand exceptions to the "general pattern."

Clean blood panels are a good thing, but by themselves prove nothing.  I had massive HL involvement virtually everywhere in my body below the jaw, but even at that time had near-perfect CBC results.

MSK is the best-of-the-best, in the world.  They will get to the bottom of this.  I wish you both well. Share what you learn, if you are so disposed,

max

EB303
Posts: 22
Joined: Sep 2017

Thanks, Max. My wife had Lymphocite Rich Classical HL. She responded well to the ABVD in that after 3 cycles, her scans were clear. Her doc actually did heavy research on HL and the effectiveness of chemo without radiation - and she didn't receive any radiation either. You can check him out. David Strauss out of MSK.  Since the side effects of the chemo were minimal (mostly just heavy fatigue and mouth sores) he wanted to go with all 12 infusions. 

But I hear what you're saying about location of recurrence. I can't help myself from googling tho, and everything I read about tumors / enlarged lymphnodes on/near the sternum were ALL "under" the sternum - internal and not felt externally. I guess that's why I turned here. For all we know, it's nothing at all (praying for such).

Will certainly update when we get the results.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3257
Joined: May 2012

EB,

For probably 20 years or so, "advanced" cases of HL (stages 3 or 4) have not been treated with any neoadjuvant RT, but rather chemo only.   A few patients do get RT, but it is very uncommon in advanced disease (while more common in incipient stages).    There is data also that suggests that large dose chemo with RT added increases the chances of later leukemias emerging; not a huge increase in risk, but discernable.  It is also the norm to finish all planned cycles of curative treatment.  Her possible recurrence now shows the wisdom of this, even if perhaps in her case it was not successful long-term.

I had dozens of nodes over 3cm in size, and some over 4cm.  Throughout both axillary, wrapped around the esophagus, crowding the heart cavity, wrapped around the length of the superior vena cava, in both lungs, and covering the spleen.  But I had NO palpable nodes at beginning of treatment, and still today, I have never felt a palpable node in my life.  Two days before my CT which confirmed my disease, my very experienced family doctor felt both axillary in detail, and said he could not detect any enlarged nodes for some time, but then said that he 'thought' that he had found one.   He was looking for them due to a heart ultrasound that showed my angina pain was from nodes crushing my heart.  About 10 days later when a surgeon removed my biopsy node from my left armpit, he said it was "golfball sized," but added that "I had a lot of others near it to choose from."  I was not overweight at all, maybe 165 pounds.  Ergo,  feeling or not feeling a given node has never meant much to me as a diagnostic indicator.

Your last sentence was the best:  For all we know, it's nothing at all. That is certainly my hope as well.

max

EB303
Posts: 22
Joined: Sep 2017

Hi Max

Results came back clean! Very good news. Her scans looked great, Her onc felt the lump on the sternum and said that it's likely nothing at all but could be muscular. He said an enlarged lymph node would not appear like this, not would a secondary tumor. To be at the surface it's likely either muscle or bone. She's seeing her (new) PCP in a month and will follow up then if it lingers but by all accounts - no lymphomas.

Thank you again for the advice and feedback. 

Best

EB

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3257
Joined: May 2012

Delighted to hear the good news,

max

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