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Flnative
Flnative Member Posts: 10
edited December 2020 in Just Diagnosed

Hi All,

In 2018, I had a lumpectomy and radiation for invasive ducal carcinoma left breast. I first was on anastrozole but experienced some side effects and have been on Letrozole now for over 1.5 years. Last May, I went to the ER for a kidney stone (confirmed on scan) but also had an incidental finding that ended up being left lower lobe cancer - a new primary, unrelated to the breast cancer (non smoker).

Earlier this month, routine mammogram finds some calcification. Biopsy shows a recurrence in left breast (+. +, -) and another morphology of -, -, +. Double mastectomy is schedule soon but very curious if anyone has had a recurrence of hormone positive when on an aromatase inhibitor? Does anyone know how this would typically be treated (I.e., chemo) after surgery?

Thank you



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  • LivinLife
    LivinLife Member Posts: 1,332
    edited December 2020

    Hi Finative! I really can't answer the questions you have. I know I saw a recent post by someone who experienced a recurrence while on hormone treatment; can't remember tho I think it was an AI? I'm sure this happens though uncertain how common it is... I just want to welcome you! You have a lot you are dealing with, esp. two different cancers simultaneously with one being a recurrence... Have you undergone genetic testing? If not I would recommend it! Lung cancer not caused by smoking is often environmental as well. Have you had your home checked for radon? Not sure if you live in a high radon area.... I had never heard of such a thing until I moved to PA - before I bought my home I had it tested given all the buzz around here.... extremely high levels so a radon mitigation system was a must before I agreed to closing terms....

    I hope you already have a medical team you are comfortable with, including for this recurrence of breast cancer. Hopefully you've been exploring other forums too? I'm assuming this recurrence is IDC as well? There will be others who will add their thoughts and knowledge....

    Edited to add: There are also threads related to Recurrence so check these out too if you haven't already....

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  • Flnative
    Flnative Member Posts: 10
    edited December 2020

    Thank you. I will check the other forums out as well. Yes, the recurrence is IDC, but interesting that there are two different morphologies.

    Surgeon has recommended genetic testing; there are genes, she said and there are an absence of genes, both can be critical with monitoring.

    Appreciate you input and thank you for your response

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  • Beesie
    Beesie Member Posts: 12,240
    edited December 2020

    Flnative,

    I'm sorry you are dealing with a recurrence. Anti-hormone therapy reduces local recurrence risk by approx. 50%, so this does mean that some people will experience a recurrence despite being on an AI or Tamoxifen. Not sure how many of those people you will find currently active on the discussion board but yes, it does happen.

    Are these new calcifications in the exact same area of the breast as your previous diagnosis? If not, then this could be a new primary breast cancer, unrelated your first diagnosis. That could certainly explain the different hormone status. But even if this is a recurrence of your original breast cancer, hormone status can change with a recurrence. It's most common with PR, but it can happen with ER and HER2:

    Evaluations of Biomarker Status Changes between Primary and Recurrent Tumor Tissue Samples in Breast Cancer Patients https://www.hindawi.com/journals/bmri/2019/7391237...


    Changing ER, PgR, and HER2 status between primary and recurrent breast cancer https://ascopubs.org/doi/abs/10.1200/jco.2012.30.2...



    As for treatment, with an HER2+ cancer, unless the tumor is very tiny (5mm or smaller), chemo and Herceptin are always recommended. Even with a smaller tumor, given that this is a recurrence or your second breast cancer, these treatments are likely to be suggested.

    Where are you in the progress? Have you seen your Medical Oncologist yet?


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  • Flnative
    Flnative Member Posts: 10
    edited December 2020

    Beesie,

    Thank you for your response. Fairly early in the process, saw the surgeon and scheduled the surgery. Med onc have not seen just yet (since biopsy), I have a scheduled appt with him next month. He has been following me since the first diagnosis and with the lung ca too. I have blood work early Jan and will see him a few days afterwards.
    I knew there was a possibility the hormone receptors changing, was curious about whether I was facing chemo or not. Just want to be somewhat prepared to hear those words ahead of time.

    The calcifications are close to the original site, and still small. Apparently my timing of radiology testing has been remarkable in catching disease at somewhat early stages; so grateful for that. Like my lung cancer, the breast biopsy path report did show lymphovascular invasion. Still learning about LVI, the onc seemed a little concerned about it when we talked through the lung path report (increase monitoring) but no other treatment for the lung other than the lobectomy. Funny everything is on the left, even the bone spurs in my foot, lol.

    Thanks again

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  • ShetlandPony
    ShetlandPony Member Posts: 4,924
    edited December 2020

    With all that is going on, I would want to check in with the medical oncologist *before* surgery. It may be you should have chemo first.

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  • buttonsmachine
    buttonsmachine Member Posts: 930
    edited December 2020

    flnative, ((hugs))

    I agree that checking in with the MO before surgery is a good idea.

    I recurred locally while on Tamoxifen the first time, and was on Faslodex when I had my metastatic recurrence. So yeah, unfortunately it can happen.

    Strangely too, one of my metastatic cancers came back Er-/Pr+ Her2-, which is rare. Anyway, cancers do change, and with time some people have multiple types of cancer going on. The "upside" is that receptor changes can sometimes open up new drug options I suppose.

    I hope you find some answers. Please keep us posted on how you're doing.

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  • Pessa
    Pessa Member Posts: 519
    edited December 2020

    I had IDC 10 yrs ago. Bilateral mastectomy, chemo, AI for 9 yrs. No recurrance. During all that I developed a primary lung cancer. Still receiving treatment. There was a thread here for people who had breast and lung cancer (both primaries). From my lung cancer groups I have met several who had breast cancer then developed lung cancer. I also had a melanoma 27 years ago (no recurrance)

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