Now Left Breast - Recurrence or New BC?

Myrajuc

Hi,

IDC Stage III-B in September 06.  Neo-adj AC and Taxol/Herceptin to shrink, didn't shrink.  10+/16.  Right Breast Mastectomy, Chemo Taxol/Herceptin, Radiation.  Then continued to Herceptin for a year (June 08).

Symptomatic coughing October 08, confirmed Stage IV Mets to Lungs and Rib (bones) February 09. Was on Oxygen for 3 months, fluid drain in lungs.  Navelbine, Herceptin and Zometa.  Stopped Navelbine September 09 (take a break, bone pains).  Continued Herceptin and Zometa.

Early November (a month ago) lump in left breast.  Hard and big, around the nipple.  Similar as right breast.  Confirmed 2 lumps and IDC.  ER/PR-, same as previous right IDC.  Waiting for Her2 status.

IF Her2+, then it's a recurrence. 

IF Her2-, then it's a new cancer.  Then mets to lungs and rib could be from the new cancer?  Should consider Lapatnib (who here had/has Lapatnib?  I haven't had time to research).

Either/or would continue with chemo.  Question is, what chemo combo?  And continue with Herceptin?  Of course Zometa.  But anything else for the bone?

Had MRI for back, diagnose is not mets, but arthritis, or spindylosis.  I'm 40 right now (was diagnosed at 37).  Will need to schedule with ortho for treatment (radiation? therapy? just Zometa?).

Surgeon not sure to do SNB.  What for, he said? I will be treated with systemic chemotherapy anyway.  I want to know!  So he will do an SNB.  My Left Breast Mastectomy is tomorrow.  Question is, if SNB is positive, do we remove the lymph nodes?  I no longer have lymph nodes on the right from the previous mastectomy?  Radiate or just trust chemo should work?

Need to know your input, please!  I will check back after I get released from surgery.

Thanks!