A Rare Case

ChicagoGirl · November 2016

Hello Ladies, I hope all is well..

I just recently approached the 4th yr of being dx with stage IV HER2 positive cancer, upon dx the cancer had already metastasized to the liver and spine. The prognosis given was 2 to 4yrs, I'm so thankful to have made it to this point. However about a month ago I had scans which showed a mass in the left breast (I had a mastectomy of the right breast in 2013), I was sent for an ultrasound which lead to a biopsy and MRI which showed the mass to be malignant and to be ER and PR positive, the doc also stated this was both invasive and non invasive.

I recently had an appt with my doc and the surgeon who did the mastectomy of the right breast, they were very thorough with my in explaining my case as well as the options. The options given were of course removing the left breast or going on a anti-estrogen med. According to the MRI no lymph nodes were seen and the tumor doesn't seem to be more than 5cm in size but this can't be absolutely confirmed until the surgery is done, if I choose this option. The docs feel surgery is the best options as this tumor should be aggressively treated due to my history.

I am 37 and a single parent of two boys 18, and 10 and this is very hard decision to make. On one had I want to get the mastectomy to have this mass removed but will still have to be on anti-estrogen meds and on the other hand I have been thinking about trying the meds to see how things go with that but also thinking what if the tumor increase and spreads to the lymph node or even gets bigger in size.

I really appreciate your thoughts and feedback on this..

Thank you!

JeninMichigan · November 2016

Hi Chicago Girl.

I am so sorry about your diagnosis. If it were me, I would get the mastectomy and get rid of the cancer before it hits the lymph nodes. When I was diagnosed stage IV, we did the lumpectomy and completed local therapy even though It had spread. Not sure if that contributed to my long run with NED (over 8 years) or not. I would do it and soon. Wishing you all the best. I know being a single mom myself it is terrifying!!!

Jen

Kandy · November 2016

Hi, so sorry you are having to deal with this new issue. First off congratulations for doing so well for the 4 years. I am sure with being a single parent, and so young, all of this is very difficult for you. With that being said, I agree with Jen, I think I would want to be as aggressive as possible. But I also think this decision has to be right for you. Think about it, weigh the choices and make your decision. Whatever the outcome never look back with regret. Believe that under the circumstances you made the best decision for you and your family. I wish you the best.

Bestbird · November 2016

An article that may be helpful in formulating a decision is: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922396/

Best wishes, whatever you decide!

pajim · November 2016

I agree with Kandy and Jen but for a different reason. And you can totally ignore me.

It feels like you have had a local recurrence. A second primary cancer. If you didn't already have mets, you would have surgery and radiation to get rid of this. Since you're doing well on the treatment you're currently taking why would you want to rock that boat?

There are three caveats. One is whether they're going to put you on an AI or another hormonal treatment regardless. If so, then maybe a mastectomy isn't necessary. The second is whether this mass isn't really a second primary. If your original tumor had a small number of ER+ cells, the therapy you are on killed the HER2+ cells but left these alone to grow. And they chose to grow in your breast. Not sure what the docs think about that possibility. Third is I don't know how difficult the surgery was for you the first time. If hard, maybe you don't want to go through that again.

Regardless, any decision you make is the right one. There is no wrong answer. It has taken me a long time to realize that. I always think that if I got enough data, or read enough stuff, I'd be able to make the "right" choice.

Good luck!

3-16-2011 · November 2016

Wow

I dont know if I have much wisdom for you. Just wanted you to know I am sending positive thoughts.

Sometimes a second opinion can help clarify decision making.

Peace to you and your sons.

Mary

ChicagoGirl · November 2016

Thank you ladies, I appreciate your comments and well wishes.

Surgery wasn't too bad for me the first time but just don't want to go through the same crap again. Also either way, surgery or no surgery I will need to take anti-estrogen meds..

MargaritaMS · November 2016

hi Chicago Girl,

Sorry to hear that you are facing yet another difficult decision. I was diagnosed a year and a half ago, also with mets to liver and spine. Originally, I was told likely no mastectomy since the cancer had already spread beyond my breast. However, after a good run on Taxol, my scans showed signs of cancer only remaining in my breast. My doc then said that she would hate for progression to occur due to leaving the breast intact since it was the only place it was evident. So I had the mastectomy. The next scan after surgery showed no sign of active disease anywhere! Well, that only lasted for 4 months before my spine lit up again so more Taxol. However, for me, it is easier to think that we have (hopefully) conquered 2 of the 3 original sites (breast and liver) and the spine remains the battle ground. I feel like getting after the beast anyway possible has to be good and different parts of the body offer different opportunities. I have no regrets about my mastectomy other than I wish I had done it 15 years ago when I had a stage II diagnosis. Don't know if this helps but wanted to share my experience. Good luck, whatever you decide!

Margar

A Rare Case

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