BC Recurrence after 5 years with Mets in Ribs and sternum

[Prasath_sas]

Hello all,

My mom had been diagnose with breast cancer in 2011, lumpetocomy was done at that time and done with 6 cycles of chemotheraphy(Cyclophosphamide,5-FU and Adrim), Now again in 2017 recurrence happened in chest wall with mets to 1st and 4th rib.She undergone a surgery and now had concurrent chemoradiation(4 mild doses of CMF + 30 radiations(3DCRT).Our onc now suggested to take another 6 doses of taxol(followed by hormonal theraphy).we are very much disturbed and wanted to know whether the treatment line we currently going are correct and will taxol help for a progression free survival in coming days.Any body pls help. She ER/PR + and HER -

[kontak TeamBCI]

Hello Prasath. Did she have radiation in 2011

[Prasath_sas in reply to kontak]

No she didn't have radiation in 2011

[itirp_2001 in reply to Prasath_sas]

I think chemo with radiation would have stopped the recurrence. what stage was the cancer

[Prasath_sas in reply to itirp_2001]

In last may 2017, we had a pet scan, there was Suv uptake in ribs only..

[roxboxfox RadiationOncologist]

Please seek second opinion from an oncologist who will have the advantage of reviewing all your records and reviewing the scan plates..

Reviewing the doses given, understanding the intention it which concurrent ChemoRadiation was given.

Reviewing the response achieved and understanding the intention with which Taxol is being offered.

Wonder what mild dose CMF means.

Don't know the age of your mother.

It helps to know that she is ER/PR +ve and she will certainly benefit from Hormone Therapy...And Cancers progressing after 5 years...Usually have good biological behaviour.

They were under hormonal control for all these years and it's just that after 5 years most patients go off Hormones, that's when the relapse occurs.

Breast cancer treatment is so Individualised that for same tumour characteristics there can be multiple different therapeutix options and different philosophies of oncologists based on their experiwnce and skills.

It's very difficult to comment on particular scenario without knowing the full story

[Prasath_sas in reply to roxboxfox]

Hello Sir, Thanks for the reply. My mom was not under hormonal theraphy at the time when she was diagnosed in 2011.Now our onc suuggested to put her on hormonal therapy once the chemo was done.I think hormonal therapy will help in not spreading the tumor to other organs,please share ur thoughts on the same and please explain me regarding hormonal therapy

[roxboxfox RadiationOncologist in reply to Prasath_sas]

Was her previous cancer ER/PR NEGATIVE.

do we have evidence that the current cancer is ER/PR +ve

Your Oncologist will surely guide you in right direction

All the best !!

[Prasath_sas in reply to roxboxfox]

Thanks for sharing your thoughts sir,In previous cancer we haven't took er/pr test,,we took only 6 doses of chemo.In case of current cancer er/pr test was done and results are ER+(8/8), PR+(4/8) and HER2-.Will it have a good prognosis sir,,please share your thoughts on the same

[roxboxfox RadiationOncologist in reply to Prasath_sas]

Prognosis is relatively good.

She has Metastatic disease which remains incurable but certainly treatable...

She needs lifelong hormones, Bisphosphonates ( after DEXA scan Test) , and suveillance with routine scans done at least 4-6 monthly.

[itirp_2001 in reply to roxboxfox]

why was the ER /PR not checked. That's the first thing they do normally. Without the hormonal tablets she was open to risk of recurrence. Always seek 2 or 3 opinions.

[Prasath_sas in reply to itirp_2001]

Yes it was checked, ER/PR + and HER2 -. Now she was under hormonal therapy (letrozole -2.5 mg)

[Prasath_sas]

Thanks for sharing your thoughts,i will seek for a second opinion for the same.In the meantime can you please suggest some good cancer centres in chennai or coimbatore .Please help

[Prasath_sas]

Any one please suggest any good cancer centres in chennai or coimbatore .Please help

[trpl in reply to Prasath_sas]

I took treatment from CMC VELLORE

It's a good hospital, reliable, efficient doctors

[Hidden in reply to Prasath_sas]

Adyar cancer institute is very good.

[Prasath_sas]

Hello Doctors,

Need your valuable suggestion on the below point

We had went for pet scan last week which showed the below findings

Lesions in ribs was totally cleared in this PET Scan( previously it was present in 1st and 4th rib (max suv - 5.8), increased uptake in left sternum suv - 6( previosuly the suv is 3.5), Doctor prescribed to take femara(letrozole 2.5 mg) and monthly once bone injection , but he was telling only the survival rate will be 2 to 3 years.. And he told No chemo required..i am very much worried..please advise us whether we are going in right path do we need any chemo or radiation

Note : he already undergone one cycle of chemo(taxol + carboplatin)

[Prasath_sas in reply to Prasath_sas]

Hello Doctor,

It will be very grateful if you share the feedback on above mentioned ,,Please share your thoughts