Stage 2b, triple+bc, ct =cysts on liver, slightly enlarged mediastinal node& calcif on thyroid node. what order most critical to rule out malignancy?

Depends: How long ago were you diagnosed? Are you on endocrine or any therapy at present? How much is "slightly enlarged"? Was this seen on a previous scan or is this your first scan? Why was the ct ordered? Is the ca 27.29 elevated? Further workup for those mediast. Nodes may be: to repeat ct in a short interval, to do a pet, or to go for a biopsy. It depends. Best 2u.

PET/CT scan: I would recommend a pet/ct to check out each of these areas and is approved for stage ii breast cancer. The mediastinal lymph node has to be >1cm for the pet to tell whether it is "hot" or not, so keep that in mind. The liver cysts are most likely just cysts, but the pet scan will tell if they are hot or not. Same for the thyroid. Each of these is likely benign, but the pet is most helpful.

Pet/Ct or f/u Ct: Follow up of the ct scan or pet ct scan at this time maybe helpful to see if there is worrisome characteristics in mediastinal lymph nodes. If the lymph nodes are large enough and worrisome for metastatic disease the biopsy can be obtained. The cyst in the liver can be followed up.

Need more info: Is there an older chest ct to compare the mediastinal ln to? That node is what I am most worried about. Pet/ct may help, especially if that node is bigger than 1 cm. Thyroid nodule should be evaluated with neck ultrasound and could be biopsied, but is not likely breast cancer metastasis. Liver cyst, assuming correct interpretation, is a benign finding and can be followed.