Breast Clean but Cancer Now in Liver?!?
My Mom was diagnosed April 2007 with Stage 1 breast cancer (her left breast) She had a lumpectomy in May 2007. Nodes were negative. In June 2007, they went back in for clearer margins. Since she was healthy, in July 2007, she started 4 rounds of Chemo, finishing in September 2007. The cancer was supposedly all gone prior to chemo---the chemo was an "insurance policy" against it coming back. In November, she had 6 weeks of radiation. December 2007 she started Arimidex. She's gotten mammograms every six months and all has been clear. She has felt wonderful. A week ago, she went for her usual mammogram. However, in addition, the doctors requested a chest MRI to have as a baseline for future reference. Well, a part of her liver was caught in the MRI (turns out to be a blessing) and after a CT scan, PET scan, 2 ultrasounds and blood work, we received confirmation last night that she has liver cancer (from her breast cancer).
Her oncologist believes the Arimidex hasn't been working. She goes in for a biopsy on Friday to confirm that the cancerous tissue is the same type of cancerour tissue from the breast cancer 2 years ago. Next week we meet with the oncologist to discuss her treatment options---sounds like more Chemo since surgery isn't an option right now (too many masses of cancer).
Is this familiar to anyone? I can't grasp the face that the cancer is back. She supposedly was cancer free prior to chemo---and chemo, in theory, should have killed in remaining cancer cell that was left.
This board got me through my Mom's cancer 2 years ago---I'm back and hoping to gain the same knowledge and power as before.
Comments
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Shopper, I am so sorry to read of your mom. Unless they did a PET/CT after her original diagnosis, when they said the cancer was gone, they meant from the breasts. When I was dx'd I had a mastectomy and then before chemo and radiation they did a baseline PET/CT. It was clear, I was considered cancerfree and went on to do the "insurance policy" too. Almost exactly 2 years to the day I was found to have extensive bone mets and a spot on my liver too. I was SURE I was done with the breast cancer and had moved on with my life. I was on tamoxifen and obviously that wasn't working. Cells get loose from the breast and lurk in another area of the body too small to see. There are other AI's other than arimidex (I am on Femara) so maybe the onc will try one of those and if the liver is too compromised they will start her on a chemo. NOT the kind she had originally. They consider those (like A/C ) as the big guns. There are even chemos out there that are in pill form now. Also there are some targeted chemos and rads treatments for the liver that you might ask about.
You are a great daughter, your mom is very lucky. Hang in there, and let us know how things are going. We will be here for you again. Hugs, Marsha
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Sadly this is an all too familiar occurence. Cancer is a sneaky beast and it only takes several cells to start growing elsewhere-and of course, any cells which escpae the chemo, cannot be detected on a scan. I must admit, I always hold my breath slightly when I hear people claim that they're "cancer free", as sadly it can and does recurr quite often. Sometimes soon after primary diagnosis-like your Mum. Sometimes much longer-like me-I had 12 years between primary and secondary diagnosis.
However, there are many treatments which could help your Mum, and once you have the biopsy results, do come back and update us, and we'll see what we can do to help/advise. In the meantime, hope you are all coping as well as possible. Good luck.
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Hi Shopper16,
Yes, this does sound familiar. I found out I had mets to my liver when I was going in for my last herceptin. I was planning a dinner out with friends to celebrate being finished with cancer. I did have node involvement, but I thought it was all taken care of. My onc said sometimes there are dormant cancer cells that don't get killed with the chemo. It is a total shock.
I am so sorry about your Mum. It sucks. Please come here, the Stage IV group, anywhere, anytime and we will help get you through this. We care about you and your Mum.
Elizabeth
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Ladies-
Thank you all for your support so far. Could you all be so kind to share the treatments you received/are receiving for cancer in the liver?
Thank you,
Shopper16
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Shopper, what you describe is very typical for breast cancer recurrence / metastasis. Hop over to the Stage IV forum and scan the thread titles, and you'll see lots of conversations about treatment regimens that women have been through for liver mets. Breast cancer loves the lungs, liver, brain, and bones when it decided to travel.
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Hi Shopper,
I went on Taxol, Carboplatin and Herceptin (and another since it was in my bones). Chemo every week for 3 weeks, one week off. Since the taxol is at a lower stength the side effects haven't been as severe as the dose-dense SEs.
I've been doing this chemo since mid December and hopefully this past Friday is my last -- getting PET scan next week. If it's all clear, I will continue on Herceptin and start Aromasin. CT scan in 6 weeks to see if it stays away.
And, don't be discouraged if it the tumors don't disappear fast - I was worried that the chemo wasn't working. It was slow to shrink at first and then bam, 5 of 7 tumors disappeared and the last 2 very small.
As Analemma said, hop on over to the Stage IV forum. And do a few searches too to find info -- sometimes things get buried in the threads or haven't been discussed for a while.
Good luck to you and your Mom!
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Ok it is familiar but it is also controversial to the fact that in all the bc brochures it is writen that stage 1 has 95% of cancerfree for the first 5 years...What do they tell us? That it is curable etc..In this forum you can see that things are not like that. I feel angree. I hope you handle it well with your docs. It is true that there are chemos that work. Good luck and keep posting..
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Vivo, I've never, ever heard the breast cancer is curable. The 95% stat for stage 1 is a SURVIVAL stat, not a cancer free stat. Plus, many of those women are older when diagnosed, so their prognosis is better than younger women.
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I agree with MJLToday....My oncologist said while I was esentially cancer free it did not gurantee it would not come back...She said I would still have some cancer cells but my body should be able to take care of them......She also said my Survival would be 95% that I woudl still be here in 5 years not that my cancer would not return in 5 years.....In fact there is data showing that the risks actually go up after the 5 year mark but between the initial diagnosis and that 5 year mark your chances of recurrence actually go down..it is AFTER this 5 year mark that it starts to go back up........Someone posted that here a while back and I have not been able to find that post lately........
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In reply to the last poster "hollyann"...I thought your risks actually go down after five yrs not up? And that the highest chance or recurrance was the first 5 yrs. In fact the way I understood it was the 3rd yr is considered a milestone if still NED...and if you hit the 5 yr mark that's even a bigger significant milestone with less chance you will recur.
My oncologist explained it to me this way...or so I thought? (But maybe I misunderstood her...it wouldn't be the first time I was wrong...nor the last.) lol
Chelee
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Chelee, that is the way my oncologist explained it as well. The longer you survive cancer free, the better your odds. I think that is true for insurance companies as well. They won't insure someone diagnosed with cancer until the 5 year milestone because after that the chances of it coming back go down.
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I have seen somewhere that the risk of er+ cancer goes back up slightly after five years, because that's how long AI's are usually given. ER- chance of recurrence continues to drop, and once the three year mark is reached, it drops a lot.
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We all just have to take one day at the time. I worry more some days than others. We do what we can to keep it from coming back and IF it does, we deal with it. We have to keep the faith that strides are being made everyday in research and hope for the best. Our odds today are much better than 20 years ago. We are all going through the what if's, but we cannot let it ruin the rest of our lives. I'm not preaching, this is something I have had to come to terms with myself to keep from driving myself crazy !! Best of luck to all and we just keep on keeping on. My oncologist told me the longer we go without a recurrance, the better the odds regardless of the er,pr status. The stats they are using are older for recurrance and the treatments are newer. I prefer to look at it this way. clubmember5
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I have a story for you. It isn't over yet. But in case someone might benefit from my experience, here goes:
I had BC surgery last Dec and Jan. I begged my then onco for a whole body PET/CT. He said there was no way the cancer could have gotten out of my breast. So he said the PET/CT was not necessary. I changed onco docs.
Asked the second onco for a PET/CT. He ordered it. That was Feb. It showed a 3cm lesion in my liver! So he ordered a CT scan. It came back saying the same thing, only 2cm. So he ordered an MRI. Same thing, only 1.2cm. He said it was shrinking! (It wasn't really) Then he said surgery would be too risky because of where the lesion was (inside the liver), and because they thought it was an Hemangioma and that piercing it could be life threatening (I might bleed to death). He wanted to wait and see if it grew! I changed docs again. I wanted to know what that thing was in my liver!!!
I found a GREAT surgeon out in Pittsburgh (I am from IL) who had a new proceedure. He wanted a triple phase CT scan done. We did it. And it showed almost nothing there!!! So now he was skeptical. I made an appointment to meet him. My DH and I traveled out there in May. He ordered an ultrasound and the lesion showed up on that! He said he could do the surgery laproscopically going in through my navel, into a major blood vessel going to the liver and get it from there. If I bled, the blood would go into the blood vessel and I wouldn't bleed to death! We signed up for surgery that day. But had to wait 6 weeks as he is VERY busy.
Well the surgery was last Tuesday, this is Monday and I feel GREAT! He removed that lesion...it is breast cancer, by the way...and biosied 6 of 12 other smaller pea to marble sized lesions growing on my liver as well. He wanted plenty of tissue to examine to be sure we chose the correct chemo.
Oh, and that triple phase CT scan that showed nothing? I have fatty liver disease. He said that the lesions camoflaged into the fat and that is why they didn't show up!
Well that is my story so far. Sorry to monopolize this page so much. It was a long story!
Ruth
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Wow, Ruth, what a story! Kudos to you for being so proactive and not giving up until you'd seen the best and received the best. I really admire you for that!
Can I get something straight? You had no nodes, and yet the bc metastisized to your liver? Eeegads! That's the sort of thing that terrifies negative node gals like me!
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I have been told that it takes years (5-7 or more) for breast cancer to get big enough for a mamo to pick up on it. Meanwhile, we all need to remember the first rule of cancer - Cancer Doesn't Follow The Rules! It can wiggle around, in and through tissue as it will. I think of it like the poison ivy I've been trying to get rid of for 7 years. I cut it out. I poison it out. But there is a major root system underground that keeps it coming back all the more. And let just one bird fly overhead and drop a seed of it somewhere and here it comes again. (I've temporarily let up on that fight.)
Ruth
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Ruth - did your original Pet/Ct scan report use the word "lesion" when it found the 3cm lesion - or did it say "cyst"?? I'm asking because I've had cat scans which show a 1.6 cm "cyst" on my liver and no one is concerned at all. My onc didn't suggest that I should have a Pet scan........and so I wonder if I need to push harder? Can radiologists really see a difference between a "cyst" and a "lesion" in the liver?
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swimangle72: Sounds just like what my local docs said. One even staked his reputation on it!!! I told him I wouldn't hold him to that. I still need his expertice for other issues. Anyway, the PET/CT was done in a large hopital in a major city an hour and a half away from me. The report said, "lesion consistant with metastises." All the other imaging studies said the same thing, except for the triple phase CT.
My local docs called it either an hemangioma or a benign cyst. My advise to you is to get another kind of image done. Go to a big city hospital, well known for fighting cancer. The radiologists there deal with this daily and have so much more experience. My liver surgeon said to stay away from the CT scans and have an MRI every 3 months for the next year.
My local docs didn't want me to leave town for treatment. It felt like they didn't want to loose my business or something. This I truely do not understand. They didn't know what to do about that spot. So they pretended it wasn't cancer?
Did you request a copy of the PET/CT burned to a CD? You still can. Just call the hospital and ask for the records department. I have done that for evey test they have done. Then I go home and open it on my computer. I could actually see the lesion on the PET/CT scan! As I understand it, only fast growing things light up on a PET/CT. My bunion, for instance lit up, too, and so did the surgical bed of my breast cancer (I had a lumpectomy, and in Feb it was still healing. Actually, it still is healing!!!) But we knew those two places were probably not cancer.
Also, none of these imaging machines will pick up on lesions smaller than 1cm. An ultrasound, you know, the kind they do on your unborn baby, is the least harmful to your body, the cheapest imaging out there, and it will pick up on the small stuff, too! So don't forget to ask about it, too!
Good luck! Hugs from over here!!! Let me know what happens.
Ruth
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OK Ruth, now you have me nervous. Like Swimangel I was told I have cysts on my liver. It originally showed up in a bone scan last Oct. I had a CT scan last month and the onc said they haven't changed in size so he believes they are cysts. I still have a t/e in, so no MRI for me. I think I need to figure out what my next move will be. Thanks for your story.
Karen
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Thanks Ruth - and yes, I did get a copy of the cat scan on a CD. (I never had a Pet/CT scan nor MRI of my liver.) The Cat scan report originally said the cyst was 60mm - which translates into 6 cm - an increase from the 1.5 cm cyst that was there last year. My onc made no mention of this to me - I read it myself when I got the report home and was shocked! I emailed my PCP and he said it was very strange and recommended I show it to my Gastrointestinal doctor. Of course I immediately went to the hospital where the scan was performed and got a copy on a CD - my Gastroenterologist popped it into his computer and reassured me saying the cyst was really only 16mm - and that it must be a transcriptionist's error because 16 sounds like 60. Next I called the Radiologist's office and demanded that the scans be re-read by a different doctor because how could I trust ANY of this report. So the head radiologist sent an addendum which corrected it - it now says the cyst is "stable" at 1.6cm since it was there last year. Other people have told me that liver cysts are very common - even my GI doc said it was nothing to worry about, but reading your story started me worrying all over again. Still my liver enzyme numbers have been fine for months now that I'm finished Herceptin and chemo.
Ruth - did you have any other symptoms of problems with the liver - were your liver enzymes out of wack - did you have any pain - any symptoms at all other than the cyst on the Pet/CT scan? My doctors all treat me like I'm over-reacting whenever I question these things........because my tumor was only Stage 1 and Grade 1, and because I had a mastectomy, they tend to just pat me on the head and send me on my way. I often need to remind them that my tumor is more aggressive than they think because it was Her2++++. Thanks again for sharing your story Ruth - and my apologies to Shopper for taking over your thread. Shopper do you know what kind of blood work was done to confirm that your mom's BC has spread to her liver? I'm very curious - how can they be so sure without an actual biopsy of the liver?
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Swimangel, my doc mentioned that if it was a tumor, the chemo would of taken care of it. (I had 6 rounds of TCH) I do not know if that is true or not. Do they treat liver tumors with the same chemos as bc? Also, I think I read somewhere that only 5% of the population has liver cysts
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KJ - after initial chemo tx for BC, treatment for the spread (or mets) to the liver will be different. It is very important to learn whether or not the BC has spread elsewhere in the body because that changes your staging to Stave IV. I can't imagine your onc being so cavalier in his attitude!
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swimangel72: What a nightmare being told everything is OK with such a dramatic growth in your 'cyst'! So sorry you had to go through that!
My bloodword for liver enzymes was 6.6, which everyone agrees is normal. I had some pain that was hard to discribe if I ate sweets, like high fructose corn syrup. Felt like I had been punched in the gut. But I have digestive issues, too. Funny that the liver and intestines are so closely connected! Yes, they treated me like I was over-reacting, too. One doc laughed and said, "So what are you gonna do about it?" I looked him straight in the eyes and said, "I'm going to Pittsburgh and have a liver specialist do the surgery!" And that is what I did. Because, like you said, without a biopsy, you just don't know whether or not it IS cancer!
I didn't do chemo the first time because two different oncs said I didn't need it! Boy, were they wrong!
kjbell: The PA doc said they treat bc met to the liver the same as bc in the breast or anywhere else. He said that is the good news because there are so many kinds to choose from.
I am eagerly sitting here at my computer waiting for the pathology report from my surgery last Tuesday. Hate this waiting game!!! But, ladies, that doc out in PA did a great job! I can't believe I feel so good today one week later! I can bend over and pick up stuff. I can cough without pain. But not looking forward to 6 months of chemo...
Ruth
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Ruth - I'm so happy you're feeling better and I'll be praying that the chemo wipes out the liver mets - and for future reference, could you give me the name of that surgeon in PA who did your liver biopsy? If you'd rather not post it here, could you PM me his name? Thanks again for sharing your amazing story!
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Google, UPMC Liver Cancer Center and find Dr. Geller. They are on the cutting edge (pun intended, haha). He has videos of liver surgery there, too. I knew exactly what he was going to do because the procedures are right there on their site in video format!!!
He also travels and teaches doctors how to do these procedures. I wish I had taken a handful of surgeons from my area with me so they could watch him operate on me and learn how to do what he does.
Good luck! Let me know what you do. Hugs!
Ruth
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Thanks Ruth - and, btw, I love your avatar - who's riding the horse? Looks like bareback (reminds me of my good 'ol days!)
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I read this article the other day , it might be of relevance, has anyone read something similar
Sorry I am not good at links but it will cut and paste
xx
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Interesting article Sue - not that I really understand the science - because if what they're saying is true, wouldn't the best treatment then become bi-lat mastectomies to remove all breast tissue, good and bad??
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This is what I thought , however , if breast cells are elsewhere then other cells must be.. it is interesting but complicated. I am going to read it again and try work it out.
There is another interesting article too.
Not related to recurrence.
xxx
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I read it again and I think these normal breast cells have to be switched on . If they are not switched on then they can last 16 weeks say the lungs.
I would think this is just an instance of some type of spread .
My gran had b/c twice both primary in both sides and she lived 40 years after a bilat Its all so confusing. She also had no tx other than surgery .
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