Question about detecting mets when mammo didn't detect cancer
Comments
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Dogsandjogs - I found my cancer by self exam too - buried under a 2.5 cm benign mass and thick fiberistic tissue. Self exams are important.
Mammos aren't that effective in dense breasts. Breast MRI should be the standard.
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Exbrngirl, I can certainly understand why you feel the way you do. What tx did you receive when the mets were initially discovered? Nothing is shown in your tag line.
My experiences are more like Dogandjogs. My small tumour was not detected in annual mammogram until it had spread through 9 nodes. They pulled my previous two years and still found nothing. And then when a lumpectomy showed unclear margins, I had a mastectomy. The pathology on my breast said that it was literally full of tumours. Some bigger than the 1.4 cm that eventually did show up on scans.
Add that experience to my friend who had 1 node at stage 2. Much better prognosis for her she and was carefully watched and scanned because she was part of a study. We celebrated her clear PET scan that June. In August she started having an unusual pain in her chest. She went through several different tx and trials and was gone 10 months later. Not an unusual situation in the bc world.
To answer the question of whether or not I want to know before symptoms ... I still have to say that I will wait for the symptoms. If I have 2 years from now whether or not I am in tx, I will take as much of those two years feeling good and out of hospitals as I can. -
Yes, my tx, and the only TC I have had, is indeed in my signature line ! Rads and Arimidex, that's it. I have never had chemo. This is a very usual course of tx for those who have mets at initial dx (and mine essentially was, since the met was found while I was recovering from bmx) and are ER+. I know everyone is different but my 2+ years have been quite normal save for more doctor visits than most people. I work full time, have become a grandmother and walked my younger dd to the chuppah. I'm going on a cruise to NZ/AUS in three weeks. I know that overall this may not help long term survival, but it's taken very little away from my life and I've yet to have progression. Of course, it't impossible to know what the course of my bc might have been otherwise. -
So basically you are living a normal life with the mets and no other tx. I don't think we a choosing very different paths then. -
No, I am on tx and will be forever! Arimidex is my tx. It will fail, eventually and then I'll move on to another AI or chemo depending on the nature of the progression. AI's are tx, at stage IV, I can't imagine not doing some kind of tx. Not quite sure what you're getting at. -
I agree that finding mets early has little benefit, in the long run, in terms of survival. Finding one small liver tumor and having a resection doesn't increase the chance of remaining Ned any longer than someone who had several large mets, did chemo and got to Ned. I remember reading somewhere that by the time a tumor can be seen on a scan it is already made up of over a million cells. All it takes is one of those cellS to survive and to multiply at another site.
There is so much that is unknown about mets. In some women, the mets spread everywhere quickly, where with others, such as me, I had very large liver tumors ( one was 11 cm), but had not spread anywhere else, eventhough the cancer was in my blood, as my tumer markers had doubled when I was diagnosed. Er+ cancer likes the bones, but for some reason er- doesn't. Not saying that er- women never get bone mets, but it is not common.
There are women who were diagnosed after me, with lower tumor volume in their liver, so their cancer was " caught early" , with the same cancer profile, who had resection who have already passed or are still living, but quickly had a recurrence and still doing chemo now. My cancer was not caught early, yet I have been Ned for almost 3 years. Why? I was lucky, I responded well to treatment.
If you talk to other long term survivors on these boards, they will tell you the same thing. It is a crap shoot. There are some women who are long term Ned on the her2 site, like 10 - 15 years, and neither one of them had their cancer caught early. One had it in multiple spots, including the brain, and the other had her liver covered in mets. Yet, here they are still Ned while I am sure they have seen many women in the last 10 years who " caught their mets early" yet still died a few years later. -
I am still on tx and probably will be forever. So not much would change for me until I am symptomatic and then they will bring out the big guns and all that goes with them again. -
Hi pip,
Please forgive my ignorance, I thought stage III got to finish tx at some point in time. So, it appears that us stage IV gals don't have a monopoly on lifelong, however long that may be, txBTW, stage IV tx is not considered curative, we just do whatever is needed to keep the beast at bay. Is the intent of stage III tx done with curative intent? Sorry if these questions seem naive but we tend to live in our own world about these things.
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Brnx, I don't think one can really compare how it feels to live with stage 3 and living with stage 4. However, it does get to be a slightly blurry line sometimes. I am on femara. I am 50. My cancer was 3B like Pip's. The latest thinking is to keep someone like me on femara for 10 years. Some are thinking indefinitely, perhaps with scheduled breaks (I have seen 9 months on, 3 off suggested).
My treatment was done with curative intent. My 5-yr survival odds are pretty good. 10-yr, eh! I tend to think that the treatment bought me time. In spite of the curative intent, I will not consider myself cured until I die of something different. I expect to die from BC, but I hope it is later rather than sooner. -
if only it were black and white.... The tx for stage III is hoped to be curative but the expectations are not high. That is why they throw the kitchen sink at us. Sometimes I think they should do that for earlier stages too since there is no rhyme or reason (to the best of our knowledge) as to who of us who will progress. Look at yourself. Only one positive node should have been a good indicator for you to not have mets. -
throwing the kitchen sink at lower stages is not necessarily a great idea given the fact that chemo and rads carry risks. The long term survival rates for early stage bc is clearly favorable , even without the kitchen sink, so over treatment would be ill advised. The "no rhyme or reason" comes in to play with trying to predict who will recur or have mets. Yes, one sentinel node should have put me in a better position, but bc cells travel through the bloodstream as well so node negative or few nodes is not a guarantee either. I actually have no complaints except that my life will most likely be shortened. I know what awaits me but keep on keeping on. At this point, although I never forget I have bc, I lead a normal life. -
It's an interesting and very good discussion and I think it's very useful to compare thoughts, ideas, and research we all come across. Together I think we suss out a lot of information that will help us in our journeys - information we don't necessarily get from our doctors. Thanks, everyone. And sorry to Roses, we sort of hijacked your thread! -
Not a stupid question, I've thought the same thing myself. I think it might be who reads them also, my first mammo was not digital and I was told I was ok. A month later I had IIIc. Later at another hospital I had a digital mammo and saw the comparison of the 2, it was amazing to see the difference, the digital has much more detail. I asked the 2nd radiologist would you have said I was ok based on the 1st mammo, do you see anything and he said yes I do, I am sorry that happened to you. I felt very let down by the medical system and I work in it
I've also questioned this....I didn't do recon and they tell me to do chest exams. Well, I never felt anything until it was a 5x7 bulging ball and out the ducts and my entire breast was infected so, I sure as heck don't know what I'm looking for now. It was full blown before I felt/knew anything. I also get yearly PET's.
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Jenny, mine was also huge by the time I finally felt it. It was partly because I had breasts that were always lumpy as well as dense. But I suspect it is also the nature of the ILC beast, which is why it tends to evade detection. It grows in a non-tumor like way until it finally gets so big that a palpable or visible tumor forms. I always think of it as being a little like candy floss, random bits of sugar, and then suddenly this big pouf on a stick.
Brnx, one of the really difficult things with stage 3 is this feeling of being damned if you do and damned if you don't. -
And sorry to Roses, we sort of hijacked your thread!
Not a problem, what it's turned into is interesting, too! -
Jenny, one more thing -that really bites with your mammo. Not all mammos are equal, and I so wish more people knew this. Also not all radiologists are equal. A lot of doctoring is really more like art than like science - reading pictures and surgery would both fall in that category, as far as I am concerned. -
momine,
Ah, now I get it. To use the bus analogy (a standard on the stage IV threads), stage III can hear the bus, but don't know if they will ever see it. Stage IV can see and hear the bus but don't know when it will hit us. -
Brnx, yes, something like that, except that I think most stage 3 patients fully expect to have that damned bus right in front of them one day. -
Brnx, I wanted to emphasize again, I am not trying to say it is the same thing, because it clearly is not. But I also think the borders between stages may not be as set in stone, as it is often thought. -
momine,
No worries. I understand what you're saying. -
I agree with Brnx and Momine in your respective analogies. We are waiting for the bus we just don't know when or where we will be boarding. However, as stage III, I am aware of the huge difference btween 3 and 4. Huge difference. -
brnx, thanks!
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