CONTACTS 

SUBJECTS
Letter Primary Care Physician PET Scan Test Report Submit to Patient

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 9 0000, ref SDS 6 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040507 -
040508 -
040510 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Received ref DRT 1 0001 letter from Arlette to Millie and answering
040902 - Millie's letter, ref DIP 1 0001, submitted yesterday requesting a copy
040903 - of the PET scan test report, ref SDS 9 Q64G, in order to prepare for
040904 - meeting with the doctor on 060428. ref SDS 9 BF3U
040906 -  ..
040907 - Arlette says...
040908 -
040909 -    1.  I am on vacation this week, so I won't have access to it until
040910 -        next Monday, at which time I will promptly mail it to you.
040911 -        ref DRT 1 0001
040913 -  ..
040914 - If the document is mailed on Monday, Millie should get it OA 060426
040915 - which provides 2 days for review and analysis.
040917 -  ..
040918 - Arlette continues...
040919 -
040920 -    2.  We look for a trend in the CA-15-3.  Often it will go up and
040921 -        down.  It is  when it goes steadily up for a period of 4-6mos.
040922 -        that we become concerned.   Also, if the scan had shown
040923 -        something, I am sure [the doctor] would have  contacted you as
040924 -        the radiologist notifies him right away. ref DRT 1 O46F
040926 -  ..
040927 - Patient history on rising CA 15-3 suggests timely treatment required
040928 - to avoid relapse...
040929 -
040930 -            20+ from 020321 - 020603 -  3 months.
040931 -
040932 -                Treatment changed and CA 15-3 fell.
040934 -             ..
040935 -            40+ from 030106 - 040311 - 14 months
040936 -
040937 -                Treatment for IBC commenced and CA 15-3 fell.
040939 -             ..
040940 -            20+ from 041007 - 041228 - 3 months
040941 -
040942 -                Treatment stopped on 041103, then started on
040943 -                050106; however, CA 15-3 continued to rise
040945 -             ..
040946 -            40+ from 041228 - 050415 - 4 months
040947 -
040948 -                Treatment changed to capecitiabine and
040949 -                Taxotere, and CA 15-3 fell
040951 -  ..
040952 - Patient history shows radiologist called the doctor once in the past 5
040953 - years to report that CAT scan test results required taking Millie off
040954 - treatment; this was intended to avoid risks of pulmonary emboli,
040955 - reported on 041103. ref SDS 4 RZ4I  Patient then relapsed without
040956 - treatment for 3 months.
040958 -  ..
040959 - Patient history further shows numerous instances of test reports with
040960 - notices of impending disease, and there was no call to alert the
040961 - doctor, most recently on 060217. ref SDS 6 DH4O  An earlier example
040962 - was the meeting on 030109. ref SDS 2 L66M  Later on 030710 CT test
040963 - report found skin thickening left breast that can present dermal
040964 - lymphatics for cancer; recommended correlate clinically. ref SDS 3
040965 - GJ69  In both cases there is no record of a call from the analyst to
040966 - alert the doctor about reading the report carefully.  Written notices
040967 - have therefore been overlooked due to a hectic schedule.
040969 -  ..
040970 - This record supports timely review by the patient of test reports for
040971 - assisting the doctor in focusing professional expertise on planning a
040972 - course of action.
040974 -  ..
040975 - The obvious question mark is the upcoming vacation.  If CA 15-3 stays
040976 - below 60 by the time of the vacation, this may be okay to travel.
040977 - However, if we are trending toward 80 in 4 weeks, vacation may be
040978 - disrupted.  On 030710 the doctor cited CA 15-3 at 80 as a target for
040979 - treatment. ref SDS 3 WS42
040981 -  ..
040982 - We don't want a situation where after vacation, CA 15-3 has hit 110,
040983 - and we are back in emergency mode.
040985 -  ..
040986 - Recent examination of the left breast shows no signs IBC inflammation,
040987 - so that may not be the problem.
040989 -  ..
040990 - Obvious targets of inquiry are both axilla, the left supraclavicular,
040991 - and the right breast.
040992 -
040993 -
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040999 -
0410 -