My dear grandma

kisersassy

 I was able to contact a med help person from John Hopkins and gave them my grandma's information from beginning to now and this is my answer they gave me.

she sounds like she is in very poor health even before the breast cancer came on the scene. Her treatment was appropriate based on the information you provided me--- lumpectomy, checking nodes, no other treatment since she was hormone receptor negative. and being node negative she wouldn't have needed targeted therapy(tykerb or herceptin). and she wouldn't have needed any scans to be done since the probability of cancer having spread was very very very low. despite all this, it looks like it did spread. there are several things that come to mind:
1. they need to verify that this is BREAST cancer mets and not another type of cancer.
2. if it is confirmed to be breast cancer, they need to get a tissue biopsy of it (and not just a fine needle biopsy that only collects a few cells). we are increasingly finding that the metastatic disease can have different prognostic factors--- ER that was negative can become positive in the distant organs for example. if that were her case then she would benefit from hormonal therapy.
I'm concerned about her dark urine, limited appetite and CHF, oxygen issues, and such however and am suspecting that she may be leaving you in a matter of weeks. it's important to get hospice involved and to make sure her affairs are in order. her wishes known. and help her and you and her family prepare for what is inevitable. She's not a candidate for chemotherapy-- her health is way too poor. it would kill her. usually when we see mets the lungs become involved before long and hers are already taxed.
This is a difficult time for you and your family. spend as much time with her as you and your family can....

Lillie Shockney, RN., BS., MAS
University Distinguished Service Assistant Professor of Breast Cancer
Administrative Director of Breast Center
Asssistant Professor,  Dept of Surgery, and Dept of Gynecology, JHU School of Medicine
Johns Hopkins Avon Foundation Breast Center
601 N Caroline Street, Room 4161
Baltimore, MD  21287
410-614-2853
410-614-1947 (fax)
http://www.hopkinsbreastcenter.org/