Breast Cancer NNP

Hello Guys!

This is the very first post by me. Cheers!

My Mother 73 Diagnosed with Breast Cancer on 21st of March. Doctor who is close to us, advised to go for surgery immediately after evaluating all films/Blocks. Surgery was over by 27th and she is as normal as before. She did not even get any sense/pain due to the surgical procedures. Feeling was great.

The worries started when my doctor advised for Biopsy and further examination. Biopsy came very normal but the ER/PR/HER 2 came as NNP (Negative, Negative, Positive).

Upon taking expert opinion, doctor advised to go for 6 Chemo cycles, Target therapy, RT and follow up.

Due to my mom age and not financially sound, we have opted not to have Targeted Therapy. I am very much worried about her for chemotherapy. It will start with 4 EC, followed by 4 cycles of Paditexel. We will take one more opinion on RT because of her age but Chemo will continue. Repeatedly doctor was asking tolerance capacity. she does her household work even today without any help. She is that confident after having Angina pain and diabetic in past.

COuld you suggest how it is going to be for us next 6 months. Is this pain full?, i believe lot of advanced drugs has come with very low power with minimal side effects. I am worried. Apart from, Hair fall, Numbness, Not feeling like eating, excessive heat in body, anything else which may happen??? and how to counter all these.

I am glad that i could able to browse healthunlocked. Please send me some of your experiences so that i can plan accordingly.

9 Replies

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  • Hello Manas - welcome to our family. Its disturbing to note regarding your Mother. As you have told the overall health of your Mother is fine. Don't take too much tension - as you have to stand by her at all the times. Now a days chemotherapy is not that difficult and can be managed well with medicines. e.g. For vomiting, temperature - the medicines are given. As this is summer season you have to take care she takes lot of liquids - like water, coconut water, water melon juices etc. Let her eat whatever she likes. Overall treatment is manageable with the help of Doctors.

    Hair loss, loss of appettite etc will be there. But once all the treatment is over - the hair will come back. Also avoid talking of cancer now all the times in front of her. Let she be with the family members whom she likes. This will help a lot to come out from this tough time of treatment

  • Thanks,

    As she is diabetic, would prefer to give some other fruits, instead of Watermelon, Coconut water etc.

    The Side effect starts from the very first cycle or it again depends on patient to patient. Do we need to stay for a day for each cycle. I also heard the dose can be adjusted based on the progress.

    Could you suggest what is the best make/company for EC and Paditexel irrespective of cost.

    Regards

  • Yes as she is diabetic. Pl do consult your Oncologist. Side effects like vomitting, loss of taste starts from the first cycle. The starting 3 or 4 days after chemo are tough. Then slowly she will be in routine.

    My sister had 6 cycles of chemo - but after 4 to 5 days of chemo she used to go to office. Just see she gets good moral support from the family.

    Chemo is usally given in day care. There is no need to stay. You have to go in morning and can return after its completed.

  • Thanks again.

    Can i get an expert advise ! i see on many research papers that Chemo is not advisable to person with more than 72 years and it's all after seeing the patient. My doctor prescribed without seeing her however she has checked ECHO2D and asked me her routine job. Confused!!

  • There is not sufficient information about the tumour, histopath report, the type of surgery to make any recommendation for or against chemo and/or radiotherapy.

    More so, it may be better you take a second opinion from another Medical Oncologist as its impossible to give any medical opinion without knowing patients history , physical status, etc.

    Treatment for breast cancer is very personalised and treatment for your mother, may not bethe same for a 45 year old lady, and even if age is same, treatment for one, may still be different from the other.

  • First of all, if it is HER2 positive, Herceptin or one of its equivalents [there are cheaper options in India] may be added - the targeted therapy; even if not financially sound. It may be the most effective drug. Depending on other important information:

    * Are there any lymph nodes affected, and if so, how many (they would have been removed as part of the surgery)?

    * What was the size of the tumor?

    Don't worry about the side effects, assuming you are in contact with those who can react on them and adjust the medication if needed.

  • Thanks Kaarenorgaard,

    Tumor Size is 5x5x3 cms.

    Margins - 1.5cm to skin

    1.5 cm to base

    Other - Grossly uninvolved

    Her 2 Positive 3+.

    Number of Lymph nodes present 27

    Examined - 27,

    Lymph with micrometasases - NIL

    Extranodal extension - Not Identified

    SKIN - Not involved

    Nipple - Not Involved

    PT2

    PNO

    PMX

  • IF it is this big, and strongly HER2 positive (3+ is maximum), Herceptin or one of its equivalents (containing Trastuzumab) is certainly advisable. And you usually have it with chemo therapy (here in Denmark always). Chemo therapy for some months (4) and Herceptin or its equivalent for a year. Depending on the drug composition of chemo therapy the Herceptin may have to wait for some of its completion (the EC part - because it contains anthracyclines that together with Trastuzumab produces too strong side effects for most).

    But it is good that no lymph nodes are affected, and the tumor doesn't have any complexities!

    Kind regards,

    - Kaare

  • By "this big" I didn't mean to say that it is unusually big. It is just because sometimes, if it is less than 2 cm, it doesn't require Trastuzumab. But that is only the case for ER+ tumors, which this is not.

    You can key in your data and get guidance on CureGPS.org.

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