Was it necessary radiation after mastectomy?

spacebmt

My mother had Wide local excision with right mastectomy Infiltrating duct carcinoma NOS(
Grade II BRS Modified) measuring 1.4X1.3X1 cm wit tumor metastasis to one of
seven axillaries lymph node with tumor size 1.4 cm size,Nipple areola, Deep margin , Free of tumor. Six cycles of chemo and tamoxifen taking. No radiation taken before or after surgery.

Due to the suspicion of malignancy, she was planned for wide local
excision followed by frozen section. Wide local excision and frozen was done
and was reported as infiltrating ductal carcinoma and posterior margin was
involved. So modified radical mastectomy was done.

After completing the last follow up with doctor two weeks later she started
having cough with scanty expectation breathlessness and left sided chest
pain it last for another two weeks. She went to a doctor and he did some
clinical testing like CT scan and chest examination and confirmed the
metastasis spread to lung and small lesion in the liver. Lung almost right
full and left 3 forth was affected. She went her regular doctor oncologist
and they did some pulmonary medical support for 10 days during their
investigation later she was given Inj.Docetoxel one dos. Later discharged
from the hospital and after within ten days she passed away.

The surgery done two and half years back.last one year she used to have tamoxifen.

please advise is this treatement  was ok for her. what could be the reason  that she could not prolong her life.After the metastasis to lung and liver she had 15 days left to treat.The oncologist were not sure how much area was invoolved in the lung cancer cells because they were suspecting the TB, and confirmed the spread bur said can start treatment only after TB test.

Was this treatement given in the begining for  Ductal carcinoma is currect. Any mistake done during the follow up. During folllow up no chest extra and CT done in last one and half year . But altra and mammo done.

Please advice yours opinion.

dlb823

spacebmt ~ I'm very sorry to hear about your Mother.  From what you've told us, it sounds like she had very appropriate care, but, sadly, some types of breast cancer are just extremely aggressive and those frequently progress very quickly, no matter what the course of treatment.  My guess is, if she did not have a CT scan initially (which there was no indication she needed), the metastisis may have been there all along.  

Some doctors are starting to recommend radiation after a mastectomy, but this is a very new trend, and not the standard of care as yet.  And radiation is actually done to prevent a recurrence in the breast.  I don't believe it would have prevented what happened to your Mother.

Your Mother's progression after the metastisis was discovered sounds especially fast, which must have been devastating to your family.  But it also leads me to believe that she may have had one of the extremely aggressive types of breast cancer that occasionally seem unstoppable, no matter what is done.  I'm so sorry.     Deanna

spacebmt

Hi

Thanks for your valuable opinion and support.My question mastectomy time it was found that BC cells are already travelled to one of the lymp node. Do you think  that time itself it might have gone to the other part of the body. So Radiation is not a solution at this time only chemo can depend. Please advise

Leah_S

I'm so sorry for your loss. I know the pain must be overwhelming.

I suspect the metastasis happened before the chemo and probably before the surgery. Since it went so fast, it was an aggressive monster - there is no other word. If chemo did not help, I don't think there was anything else that could have been done. Chemo is systemic treatment (treats the whole body) and radiation is local treatment (treats just the area in the radiation field) so radiation would not have helped in this case.

My sincerest condolences to you and your family. I can see that you loved her very much. May G-d send you comfort.

Leah

dlb823

spacemt ~ Chemotherapy and radiation therapy do two different things.  Chemotherapy treats us systemically via our blood supply.  In other words, chemo hopefully tracks down and eliminates any cancer cells that managed to get beyond our lymph nodes and are traveling around in our bodies.  Radiation therapy, on the other hand, basically sterilizes the tissue around where the original tumor existed in the breast, making it virtually impossible for any stray cells that may have been left behind during surgery to grow back in that area.  So, as Leah said, radiation would not have done anything to control cancer cells that had already passed the lymph node(s) and were determined to set up a new tumor elsewhere in your Mother's body.

You also have to keep in mind that cancer cells are tricky and they tend to mutate. This is one reason cancer is so hard to stop, because it has the ability to change its structure to survive or outwit chemo.     Deanna  

Anonymous

So sorry for the loss of your Mom. You must be in enormous pain. I just lost my Mom and my prayers are with you and your family. i have to date met with four oncologists and all four have different ideas on treatment and on the chances of  the cancer returning. And four diff ideas on how to increase my chances for survival. Non of them are good. Now I am at, wow, this is my first cancer diagnosis and I thought studies in BC had come so far-I have a sneaking suspicion that theyhave not. Better drugs maybe, but I just don't know. Anyway, prayers for your loss. SV

spacebmt

Hi,



Thanaks for all who have mede their valuable comments on this issue.



I would like to point out that after diagnosed BC and in case lymph nodes are involved oncologist might suggest chemo. But my question is that once chemo started is there any testing available for whether these treatemens are effective or chemo is responding.I heard that certain case chemo not all responding. Sometime docters are telling chemo does not respond when metastasis rule out. Please advice.