Bone and liver metastasis

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maha_007
maha_007 Member Posts: 9
edited September 2016 in Stage IV/Metastatic Breast Cancer ONLY

Hi,

I am living in Bangalore, India. My mother went to a Gynaecologist following a lump in her lower left breast. The gynaec asked for an FNAC and mammography and finally concluded that its a breast cancer(ductal carcinoma). She wanted to do a mastectomy even before doing detailed diagnostics. But we wanted to get a surgical oncologist before we actually go for mastectomy. There were many inexperienced surgical oncologists in consideration. However we waited to get one of the best surgical oncologists to get it checked. The tumor was measured to be 3.1 x 1.9 x 2.6 cms. He felt that there is no lymphnode swelling in the axilla and said its in early stage and scheduled for a lumpectomy. We accidentally said she got operated in the hip 3 years ago and he asked us to get a bone scan done. Bone scan said there is a suspicion of a lesion in the L4 vertebra and has metastasized. But the resident doctor ignored it and said we can go ahead with lumpectomy surgery. But I was suspicious about it and went to the main oncologist to consider the report. He said there are less than 5% chances of it being metastasized(may be he was hiding) and asked to get PET/CT. PET/CT was disastrous and showed there were multiple places where the cancer has spread. It has spread to L4 vertebra, left femur, iliac bones, scapula and both lobes of the liver. They have asked for a trucut biopsy to get a histopathology and ER/PR tests.

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  • Tomboy
    Tomboy Member Posts: 3,945
    edited September 2016

    Hi, Maha. I am up late, and wanted to tell you how sorry I am about your mother. If you are still here, reading, then you might see this. It is a good thing that the mastectomy wasn't done already, because maybe she can just do the anti-hormonals, depending on what they find from the biopsy, to keep it in check and get a good quality of life. It's so bizarre! It's such a good thing you were being vigilant and suspicious ! What I didn't even know was possible, is that the bone scan wouldn't show more, while the PET/CT did show everything. I think I won't trust the bone scan I had six months a go now. I didn't know they weren't effective! Shame on those doctors trying to hurry your mom through without proper testing, and you are a great daughter for helping your mother in that way. Blessings for both of you

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  • maha_007
    maha_007 Member Posts: 9
    edited September 2016

    Thanks Tomboy for your support and a prompt reply. We are going ahead with Chemo right away and thats what has the medical oncologist suggested us to do. I am not sure if there is a difference between the chemo drugs available in India and rest of the countries. Can everyone let us know what is the recommended drug for chemo if you are getting it for the first time? Does it need an auxiliary drug to control the side effects?

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  • pajim
    pajim Member Posts: 2,785
    edited September 2016

    maha_007, I'm so sorry to hear about your Mom. Glad to hear you are on top of the testing.

    So far as I know you have all the same drugs in India as they do in Europe. They may be slightly different than in the USA.

    The ancillary side-effect-type drugs totally depend on what treatment they will give her. And that is totally dependent on what they find from the biopsy. They need to test the estrogen receptor, progesterone receptor and HER2-neu receptor. The question is to find out what makes your Mom's specific cancer grow. If she is ER+ (cancer uses estrogen to grow) then they will give her hormonal treatments. If HER2+ she will get HER2 treatments.

    If there's a lot of cancer some doctors will do a few rounds of standard chemotherapy (like they give to Stage 3 women) to knock the cancer back before starting a 'maintenance treatment'. Other doctors won't.

    A lot of women live a long time with metastatic breast cancer. How your Mom does will depend on how well she responds to treatment. And if one treatment doesn't work, there are many others to try.

    Good luck to you and your family.

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  • maha_007
    maha_007 Member Posts: 9
    edited September 2016

    Hi Pajim, Thanks for the reply. Just got her tru-cut needle(the diagnostics person got 4 small chunks of the tumor in the breast) biopsy report and have concluded that its ER-/PR-/HER2+/KI-67(6%). Bad news as I know. But they have opined in the report that ER,PR and KI-67 should be done through excision biopsy because the nature of the sample is tiny.

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  • pajim
    pajim Member Posts: 2,785
    edited September 2016

    They have a several good treatments for HER+ cancer. Herceptin, Perjeta and some others coming down the pipeline. HER+ cancer used to be bad news (it spreads fast), but Herceptin stops it in it's tracks.

    Not to mention that it has few side-effects.

    Here's information on the current standard of treatment for newly diagnosed HER+ metastatic breast cancer:

    http://www.nejm.org/doi/full/10.1056/NEJMoa1413513

    (You should be able to get to this for free)

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  • maha_007
    maha_007 Member Posts: 9
    edited September 2016

    Thanks a lot Pajim, its indeed a very good article. Tomorrow we are going for a Chemo and will have to wait and watch how she responds. Wish us luck. One question, is it possible to get a liver lesion of 2x1.8 cm out by chemo and other drugs. I am scared.

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  • pajim
    pajim Member Posts: 2,785
    edited September 2016

    Oh, absolutely. I have a friend who almost died when they found the cancer in her liver. There were so many tumors they thought she would die before the chemo took effect. 18 months later and they can't find any mets anywhere.

    Every woman is different, of course, but there's no reason your Mom's met won't melt away.

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  • maha_007
    maha_007 Member Posts: 9
    edited September 2016

    thanks pajim, relief to know that...

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