Expert: Claes-Gustaf Nordquist, M.D. - 3/31/2005

Question
I have had L side breast cancer, no surgery as there was nothing showing on any mammogram.  But one large lymph node excised showed adenocarcinoma HER strongly positive. I had chemo, radiation, ending one year ago.  Now sore ribs, tender all over, getting worse.  In Dec I had three successive sharp pains from the bottom left rib, stabbing upwards.  This occurs about  once a month, but they go away in between.  One week ago a spot on the lower left rib near the waist became very tender to the touch.  Feels like soft tissue is swollen, not just bone tenderness.  My oncologist says not to worry, did a blood test for liver function, my family Dr ordered X-rays today.
I have been reading about the liver, but it always says right side soreness for liver not left.
My question- is it normal to have soreness over the ribs after radiation to the area?  How long should it last?  Would it go as low as the waist?  If soft tissue- what are the possibilities?  Could it be a hernia?  Pancreas? Spleen?  It seems to be near the surface not deep pain.  I would appreciate any light you can shed.  I need to be able to ask questions and get answers.
I received advice from you once before and it was very helpful.  Thanks for your time and expertise.


Answer
Yes liver engagement should normally give symptoms on the right side. Radiation in higher doses can cause inflammation and symptoms. Uncertain though if your description fits that scenario. Ask your dr. for an MRI scan or PET scan of your ribs together with the X-ray examination. The X-ray examination should also cover your lungs. Could be supplemented with a CT scan of them as well. Without an examination it is difficult to be more specific. Please keep me posted with the results.