Histologic grade III- Sternum metastatic carcinoma- No hope?

Sunnylife · May 2016

I live in Korea far from 1hour from Seoul. After come back breast cancer with metastatic bone (sternum), local university physician said to me that I need radiology therapy and forever chemotherapy. So I met another Physician at Seoul, and she mentioned me that there is no medication about my case and Radiology and Chemo is worthless. There is no hope for me?

I would like to hear your opinion and help about my situation. It is terrible discourages and hopeless situation to me. Please share your experience or give me advice if you have the same or close situation like my case. Is there any target cell therapy about my case?

10/7/2014 Surgery Breast Cancer left 10 o'clock

10/7/2014 Surgery Left breast lumpectomy-Invasive duct carcinoma (Malignant neoplasm of upper-inner quadrant of breast)

10/7/2014 Surgery Tumor size-1.5*1.3 cm /Histologic grade: III

Pathology report

Gross; The specimen consists of an irregular fragment of breast tissue (5*5cm ), which is covered by an ellipse of skin(2.8cm). On section, the parenchyma shows an ill-defined yellowish gray solid firm mass(1.5*1. Cm ). Several nodes are separately submitted. Representative sections are embedded.(photo +) (Slide key; A: skin, B-E; resection margins, F-G: breast mass, AXI-LN A,B: sperarately sent tissue

(10 H&E)

Diagnosis: Breast, left, lumpectomy

Invasive duct carcinoma

1) tumor size: 1.5*1.3 cm

2) nuclear grade: poorly differentiated

3) histologic grade: III

4) Extensive intraductal component: absent

5) lymph vascular invasion: not identified

6) overlying skin: free of tumor

7) resection margins: free from carcinoma(in frozen)

8)lymph node metastasis: (0/2): free of tumor

Immunohistochemical result IC14-6781-88

E-Cadherin, b-Catenin: Positive

P53, C-erb-B2, ER, PR: Negative

Bcl-2: Moderately positive in 50%

Ki-67: Positive in 90%

10/7/2014 Pathology Report No metastasis

Gross: 1-3. Received frozen are three lymph nodes, measuring up to 1.5*1 cm. Entirely embedded in three cassettes. 4-7. Received frozen are four pieces of breast tissue, measuring up to 1.5*1 cm . Entirely embedded in four cassettes.

Frozen diagnosis) 1-3. No evidence of malignancy (./3), axillary lymph node. 4-7. No evidence of malignancy, superior, inferior, lateral and medial margins

Diagnosis: Lymph nodes, axillary, biopsy for frozen; (0/3): free of tumor

Breast, resection margins, superior, inferior, lateral and medial biopsy for frozen: free of tumor

1/26/2015- 3/19/2015 Radiology therapy-#34 Left breast 6240 cGy/34fx

10/24/2015 - 10/27/2015 Chemotherapy-#1 Adriamycin and Cyclophosphamide

11/14/2015 - 11/15/2015 Chemotherapy-#2 Adriamycin and Cyclophosphamide

12/5/2015 - 12/6/2015 Chemotherapy-#3 Adriamycin and Cyclophosphamide

12/26/2015 - 12/27/2015 Chemotherapy-#4 Adriamycin and Cyclophosphamide

5/9/2016 PET Scan- Regular follow up Sternum mass

5/9/2016 Biopsy Sternum metastatic carcinoma 1.3*0.2cm

Gross: Received fresh are four pieces of gray tan tissue, measuring up to 1.3*0.2cm. Entirely embedded on one cassette

Diagnosis: Bone, sternum, biopsy

Metastatic carcinoma

Immunohistochemical result IC16-3800-3806

P53, C-erb0B2, ER, PR, : negative

HER2 receptor Negative

Bcl-2, EGFR: positive

Ki-67:50%

5/19/2016 - 6/2/2016 Radiology therapy-#10 5times every week, daily 300 cGy* 10times

Zometa Injection

5/24/16-1^st

6/21/16-2^nd

7/19/16-3^rd

Chemotherapy

Capecitabine (Xeloda)

Taking 2week and 1week break

Vinorelbine (Navelbine)

2 times weekly and 1 week break

6/3/16-6/13/16 -1st

6/27/16-7/4/16 -2nd

7/18/16- 7/25/16 - 3rd

Avastine

Every 3week and 2 week break

6/3/16

6/24/16

7/15/16

7/29/16- PET, X-ray Checking Schedule

blainejennifer · May 2016

Go back to the first physician. I'm a grade three (like you) and have been in treatment for bone metastasis (like you) for over four years now. Yes, you will need forever chemotherapy, on and off, depending on what your cancer is up to. Beginning with radiotherapy is a grand idea, as it looks like you've got one lesion? Or, the biopsy is from one lesion. Anyway, radiotherapy is a great way to knock the bone metastasis back, if it is limited in scope. 10 sessions is pretty standard.

So, the second doctor is an ass. There are targeted therapies available, but your pathology report doesn't indicate anything about your cancer except that it is grade 3, so you will have to have a conversation with your doctor about what are good options for you.

In a nutshell: plenty of hope. Once the cancer has leapt out of the breast, there's not much chance of a cure. But, it can be managed as a chronic disease for YEARS.

cive · May 2016

There are therapies available but I'm not sure which they will prescribe for you in Korea. The chemo that you previously took just won't be helpful since your cancer would have become immune to it. So the second person was probably just telling you that the AC wouldn't be appropriate. What is your doctor saying to you?

Moderators · May 2016

We agree with the others, and perhaps you could find helpful suggestions in this article:

Bone Metastases

We're all here for you!

txmom · May 2016

It looks like you are hormone receptive negative. Ask about your HER2 status. It's all very confusing in the beginning but there is hope for you.

pajim · May 2016

Sunnylife, the second doctor is nuts. Put your trust in your local university physician. Yes, you will need radiation, and yes you will take some form of chemo for life, but that life could be a long one.

One thing I don't see on either path report -- did they stain for HER2? It appears you are [still] ER/PR negative, but if your tumor expresses HER2 there are many excellent drugs you can take (Herceptin, Perjeta, etc.)

Interesting that you are EGFR positive. You can try one of the EGFR inhibitors (there are several, such as cetuximab or gefitinib).

What I'm getting at is there are many drugs you can try. There is plenty of hope.

car2tenn · May 2016

Sunny life: do not ever give up on yourn treatment and therapy. No one knows how you will do. I agree to stay with the University therapy and mainline therapies. You will find a great deal of information on this web site. Stay with us and stay hopeful. Carolyn from USA

zarovka · May 2016

Once the cancer spreads outside your breast, it is often not curable. You will always have cancer. But many people live a long time and live very well with stage IV cancer. You will have to learn a lot and you will go through some very very difficult things. But no should ever tell you not to be hopeful with the limited metastasis you have. It's a really silly thing to say. So that is a stupid doctor.

Get a second or third medical opinion whenever you don't feel comfortable with what you are being told. A tremendous amount of judgement goes into treating stage IV cancer. There is no recipe. Intelligent, experienced doctors will differ.

ibcmets · May 2016

I'm 7 years out from stage IV. chemo & radiation to the bone mets gave me 5 years stable.

Terri

Heidihill · May 2016

You should ask for them to test HER2 status of your tumors as that will give you more treatment options. Are you near Gangnam Severance Hospital? Here is a study from them and though rather complex, it shows there is hope.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC374318...

Solitary bone mets (like yours) in particular is shown to have a favorable prognosis. Also, treatment with bisphosphonates for at least 12 months is important, according to the study.

Sunnylife · May 2016

Thanks for your courageous and helpful answer. I will do my best to find out the best treatment for me. I am 38yrs old, and I have 3children; 10yrs old boy, 8yrs old girl, and 6yrs old son. My husband is very supportive for all my treatment. Thank you again.

zarovka · May 2016

I am so glad you have a big supportive family Once you figure out your treatment protocol and get started, your family will keep you too busy to worry. If that is not enough, get a cat or a dog .

Seriously, joy is the most powerful antidote to all the stress and trouble coming at you. Hold your family close and keep going ...

>Z<

PinkyTR · June 2016

Hi Sunnylife. I dont understand. Your dx 10/2014, your chemo 10/2015.. Is it true?

rosetide · June 2016

ibcmets,

Thank you for that post! That just gave me a ton of hope! God Bless You! So glad to hear of your progress!

ROSETIDE:)

catsteme · June 2016

Sunnylife - I too have had mets to my sternum and have recently had 80% of the sternum removed and replaced with artificial material. I'm now about 5 weeks out from my operation and still have a little tenderness and numbness but it's really not that bad. The operation, although complicated, has very little risk as it doesn't involve any organs. My tumour was much bigger so I would be surprised if this surgical option isn't available to you. My oncologist believes that resection is always the most effective way to remove the cancer, but the risks of the procedure must always be factored in. Very best of luck. I agree with the other ladies, the second physician is talking rubbish.

hansaim · June 2016

Hello, there. I am so sorry that you are here. I am also a Korean but live in Canada. You said that the cancer is ER and PR negative. As pajim said, it is important to find out if it is HER2 receptor positive. There are many chemo treatment options and many women with mets do well for a long time. Do not lose hope. Come back and ask questions here. There is wealth of information, experience, support and love. Thinking of you and your family.

sherrmue · June 2016

Sunnylife, I agree with everyone here. Don't give in to despair. Talk more to you oncologist and maybe get another opinion. Sometimes a different doc with have a solution not thought of. There are many good treatments for bone mets and they can be managed. Hang in there

Sunnylife · June 2016

Thanks for your helpful and supportive answer again.

I finished radiology therapy and started chemotherapy , but my WBC level is 700 now.

Next month, I will take another PET to monitor the size of Sternum metastatic carcinoma 1.3*0.2cm.

HER2 receptor is negative.

Zometa Injection

5/24/16-1^st

6/21/16-2^nd

7/19/16-3^rd

Chemotherapy

Capecitabine

Taking 2week and 1week break

Vinorelbine

2 times weekly and 1 week break

6/3/16-6/13/16 -1st

6/27/16-7/4/16 -2nd

7/18/16- 7/25/16 - 3rd

Avastine

Every 3week and 2 week break

6/3/16

6/24/16

7/15/16

7/29/16- PET, X-ray Checking Schedule

Sunnylife · August 2016

Hello, I did PET SCAN last week and showed me bone cancer is gone.

Also I will try another chemotherapy( eribulin or Halaven inj.). I tried to get the information about these medication from South Korea, but I couldn't find the case of this medication. Can anyone shares hers experience if you are taking or took? Thank you.

Longtermsurvivor · August 2016

Wonderful news, Sunnylife!

I'm glad you found effective treatment and that you didn't believe everything the doctors said at first.

Good hopes that they find your next best chemotherapy to help you live a long and healthy lifetime.

Thanks for keeping in touch with us, Sunnylife.

warm healing thoughts, Stephanie

pajim · August 2016

Congratulations! So glad the treatment worked for you.

Sorry I don't have any experience with those meds but you could look on the main breastcancer.org site.

RosesToeses · August 2016

Sunnylife, congratulations! I'm so happy for you!

I haven't been on those meds either--you may also want to start a new thread with those in the title to catch the attention of people who have.

Sunnylife · July 2019

Hello I am Sunnylife.

One year break and cancer come back again. I didn't get any chemo because I was too weak and sick. I have a plan to get proton therapy.

07/10/2018 PET scan- Sternal metastasis

07/03/2019 PET scan - Sternal metastasis

Dr stated that stable sternal metastasis and RT is not worked because of the therapy side effect. Dr recommend " Proton therapy"

Anybody got this therapy? I would like to hear your experience about this treatment.

Thank you

Histologic grade III- Sternum metastatic carcinoma- No hope?

Capecitabine (Xeloda)

Vinorelbine (Navelbine)

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