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I am new here with a ground glass opacity identified

thing3
Posts: 4
Joined: Aug 2020

I am new here, looking for advice. I have read a lot of the posts which are very helpful to calm me down.

Annual CT scans have identified a stable right upper lobe Ground Glass Nodule (GGN) measuring 5 x 5 mm with a small arterial branch courses to the center of the opacity for the past three years, which may represent an area of Atypical Adenomatous Hyperplasia (AAH). This nonspecific Ground Glass Opacity (GGO) was incidentally found in a CT scan three years ago for other medical reason. No significant growth or change has been reported in annual CT scan since then.  I feel sorry to myself that I did not pay any attention to the GGN/GGO/AAH in the past until my Dr. suggests to monitor it in annual base recently (Aug. 2020). I have some questions burning in my mind.  I am not even sure if it is a pure GGO or mixed GGO since there is a small arterial branch courses to the center of the opacity. I think I may need to make appointment with my PCP and a specialist. But I would like to know what kind of specialist doctor should I looking for before seeing my PCP. It is greatly appreciated if you could share any similar experiences and educational information. Thank you very much in advance for your time.  Good luck to everyone here.

Primavera's picture
Primavera
Posts: 177
Joined: Mar 2019

I came here last month looking for answers on a biopsy for ground glass opacities. They haven't changed in a year, though. CT scans have been done frequently for me. March, September, December 2019 and now in July 2020. 

They haven't diagnosed you with anything, right? I had uterine cancer last year and I got referred to a pulmonologist by my gynecologic oncologist, to follow up two nodules that are 3mm each and a ground glass opacity area of almost 1cm. Nothing has grown and my problem is that the lung doctor "wants to know" if it's a metastasis of my uterine cancer and wants to do a biopsy. She doesn't believe the radiologists reports of all those CT scans that say everything stable for a year and half.

Still fighting not to do that biopsy. I think it's unnecessary, at least for now. 

Your area is tiny and they're probably just following it up to see if it grows. I've read that these things grow really slowly. I don't know when mine started because I was totally healthy and didn't need any scans for about 15 years. They were found when they did pre-operative scans for my hysterectomy last year.

If it hasn't grown in 3 years, maybe it will just be followed for a few more years. They're not uncommon. In my case, they're only worried because uterine cancer metastasizes to the lung. And even though I know that, I will probably not have that biopsy, unless it grows a lot.

This board has been very quiet lately, but I hope you get other people to chime in, and I get to read more about it.

thing3
Posts: 4
Joined: Aug 2020

Dear Primavera, thank you so much for responding and sharing. I'm sorry to hear of your story that is understandably causing you concern and need to make a hard decision. I hope you will feel more at peace about the decision.

I had a robotic partial nephrectomy surgery last September to get rid of two juxtaposed lesions in kidney, that were incidentally found in 2018. It turns out the two lesions that were removed out are benign and not cancer, and no malignant features are identified.  My oncologist did not recommend  follow-up CT or anything on my kidney. The Ground Glass Nodule was reconfirmed on CT scan this August that was recommended by my cardiologist due to a concern of ascending aortic dilation/aneurysm.  In addition, a triangular-shaped nodule was also reported, likely representative of an intrapulmonary lymph node. The intrapulmonary lymph node was never reported by radiologist until this month even though it had been caught on CT images since 2018. Based on what I have learned, for pure GGN 5 mm or smaller, no follow-up scanning is recommended until it grows up to 10 mm.  A pure Ground-Glass Nodules 5 mm or smaller with 5 years’ stability can grow after 10-year follow-up.  Approximately 10% will grow and 1% will develop into invasive adenocarcinomas or minimally invasive adenocarcinomas. Therefore, they should be rescanned 3.5 years later to look for development of a solid component. Good luck,

dennycee
Posts: 841
Joined: Mar 2011

Hi, I haven't been here in a while and checked in on a lark today.  My stage 4 lung adenocarcinoma was diagnosed in October 2010.  At that time they identified several GGOs.  In the near 10 years I've been dealing with this they have not increased more than 1mm in size, which can be attributed to how full the lungs were when I held my breath or the slide they are using for comparison.  At one point about three years ago they felt that some of them may have been a bit more opaque but that has not changed since.  I will continue to have them followed by annual CT.  

are you being followed by a pulmonologist?   That would be my recommendation. 

Primavera's picture
Primavera
Posts: 177
Joined: Mar 2019

That's how it's been from the beginning. I told the lung doctor to call again in October. But then my real nightmare started.

Since I was too scared for this lung biopsy, I decided to go for my mammogram that was long overdue. A year, like everyone else; but they were following me up every six months for calcifications.

I moved my mammograms to the same hospital where I had all the uterine cancer treatment, and they rang all the bells. I was diagnosed on August 27 (that's why I didn't even see this answer) with invasive ductal carcinoma. Tumor had grown to 3.2cm and I had a lymph node also positive for cancer. After this, they did stereotactic biopsies for calcifications. Right breast turned out to be OK.

I saw a surgeon and he sent me to an oncologist. Doing chemo first. I didn't have anything except for brachytherapy for my uterine cancer. So scary. I see oncologist on Sept. 5 and also a plastic surgeon for a mastecomy with immediate reconstruction after my chemo.

Trying to stay positive.

Maybe it was a good thing I didn't have that biopsy because I would have delayed my mammograms even more and my breast cancer is aggressive. Poorly differentiated.

I'm having more lung scans now, pelvis, abdomen and also a bone scan. Then I start treatment. Will be a reader of the breast cancer forum next.

thing3
Posts: 4
Joined: Aug 2020

Dear Primavera, sorry you had to read some forums here and there, but there are a lot really great folks here and there on the forums. I got a lot of help and support which really helped me to make informative decisions, and there's a ton of great information that helped calm me down. It is always hepful to me when we know what you're going through and so you know you're going to do great. I don't have any knowldge about your condition but I definitely get the anxiety about health issues. I guess the only thing I have for you is to trust your doctors. I wish you the best in your decision, and boring treatments and a remarkable recovery down the road.

 

Primavera's picture
Primavera
Posts: 177
Joined: Mar 2019

Yes, reading how other people go through the same kind of health problems definitely makes you feel better and helps you make informed decisions. The information in these forums is invaluable. And you meet great people here. The women at the uterine cancer are still holding my hand, even though I didn't have a long treatment for that one and I'm reading the breast cancer forum now, and some of the lung forum.

Thank you for the well wishes. I wish you the same.

dennycee
Posts: 841
Joined: Mar 2011

Don't let the lung thing slip though.  Do stay on top of it.  My invasive ductal carcinoma was diagnosed 4 years to the day of my lung cancer diagnosis.  I'd put off the mamm for a couple years thinking my thoracic CTs would catch anything.  Wrong!   Have you spoken to a genetic counselor about BRCA1/2 testing?   From what you've written the hospital is being very thorough with the follow up testing.  

it occurred to me that you could get good information about GGOs at the Go2 Foundation website.  They have lots of good plain English information pages.  Do let us know what you learn.  I'll try to remember to check back sooner myself. 

thing3
Posts: 4
Joined: Aug 2020

Dear dennycee, Thank you so much for your sharing which make me understand more about GGO.  I am glad you have been completely survived from an awful disease and feel so proud of you, based on my understanding on your case. Take care!

dennycee
Posts: 841
Joined: Mar 2011

Thanks for your kind words.  The better we understand what we have the more active each can be in their own care.  Engaged patients tend to live longer. 

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