Stage 3C & on AC - TH & RT regimen (ER -ve, PR -ve, Her2 +ve)

[Imorsh]

Dear friends,

My mum (55 yrs) has recently been diagnosed with breast cancer and has gone through mastectomy of left breast with 11 lymph nodes removed, out of which 10 are cancerous. 1 apical node extracted during the operation was clear.

I wanted to know if any of the friends or well wishers here experienced the similar prognosis and gone through above regimen. If so, what's the outcome?

According to our current oncologist, PET test is still required as she is only going through the 1st Chemo. In your experience, are we on the right track i.e. shall we do PET test after 4 chemo cycle?

Also, we hope to consult with a medical oncologist for regular check up and wanted to know if there is any specific oncologist/clinic in Kolkata you would recommend. When TMC is on the card, we are a bit stretched in terms of time so assuming private clinic/oncologist will be quicker in terms of test results & prognosis. We intend to travel to from Bangladesh.

Please advise.

[roxboxfox RadiationOncologist]

She needs a baseline CT scan chest abdomen and Pelvis. If affording , only then one may go for a PET scan.

Ideally this needs to be done prior to starting treatment (chemotherapy), i m unsure of the role of imaging midway after 4 cycles of chemo and i m unsure whether it would change anything.

She would need Adjuvant radiotherapy and if she is hormone sensitive -- Hormone therapy may be indicated.

Of course, if she is Her2+ve, she may benefit from Herceptin as well

Thanks

Rohit Malde

[Imorsh in reply to roxboxfox]

Thanks for this. We are using all the scan done prior to the surgery as baseline. Chest xray, bone scan, ultrasound of kidneys and TVS all came as clear. Duration between surgery and first chemo is 21 days. Do we need new tests/scan for baseline?

Please advise.

On a separate note, she just started adjuvent theraphy with first chemo and we are following AC - TH and RT regimen.

[sumeet_shah Administrator in reply to Imorsh]

Baseline means just before starting any form of treatment. There is no sense in doing any tests midway, unless some has some symptoms.

Doing any test now wont change the treatment. If the PET is normal, she will go ahead with chemo and RT. Even if the PET is abnormal, she will still need to do the chemo. So you see, we do tests only when they are likely to change treatment.

The reason your Oncologist has suggested PET is the high burden of positive nodes, which places her in Stage 3C. You can discuss with him and see. I suggest you follow him, whatever he says.