instruction: hello doctor I am a 64 year old female operated cancer breast and cancer rectum I completed the treatment for breast cancer I underwent neoadjuvant cart and anterior resection with covering ileostomy for cancer rectum I completed adjutant chemotherapy and ileostomy closure done my it thorax shows multiple enlarged left retro pectoral nodes
output: hello as per your reports your mammography is normal it computed tomography shows retroperitoneal lymph nodes and multiple hypodense lesions chances for breast cancer recurring after 10 years are usually unlikely what can you tell about your baseline stage of cancer breast and cancer rectum as serum sea levels are normal there is discordant radiology and serological picture I would like to view it films and if previous it films are available the it is definitely abnormal liver lesions can be simple cysts too if that is the case I would not give much importance to retroperitoneal nodes and just advise you to be in close follow up may be repeat sea and it after three months there are no definite guidelines for this type of situation and the plan of action depends on experience and clinical judgment regards how likely is the recurrence if symptomatic I would advise you to follow up most likely the picture looks like recurrence of cancer rectum but as treatment was completed more than three years ago recurrence this late is not common and chances of different diagnosis like to tuberculosis or invective cause can also be there