Breast Cancer India
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Please guide!! My mother diagnosed with BC

Hi All, I am Maddy from Delhi. My mother ages 58 years, recently diagnosed with BC Infiltrating Ductal Carcinoma Core Grade II. She has undergone Mastectomy procedure three weeks back.

Histopathology parameters:

Grade: II

ER/PR: Positive

Her2 : Negative

Lymph nodes: (1/25) Total twenty five lymph nodes identified, of which one Lymph node shows tumor metastasis.

Final size of invasive tumor: 4.0cm(superolateral) x 2.5cm (mediolateral)x 1.5cm(anteroposterior)

Doctor advising to go for Chemotherapy (4 cycles), Radiation and Hormone therapy for further treatment.

Pls advise as chemo is required in this type of case.

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Any tumour more than one centimeter usually needs chemo. And especially if it has gone into nodes.

In any case, your mother is In stage 2B. Don’t worry, it’s not an advanced stage at all. Just follow your Oncologist and complete her treatment. She will be fine soon. We pray odor her to get well soon.

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Thank you Dr. Sumeet for your kind advice... :)

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Hello Dr. Sumeet,

sumeet_shah

I have gone through a widely used UK software model that helps to decide on the ideal course of treatment following breast cancer surgery.

predict.nhs.uk/predict_v2.0...

As per my mothers reports, this model predicts that the benefit of doing Chemotherapy would be only 3% and Hormone therapy would be 7%.

Does the chemotherapy is really required in our case? Is there any alternative to Chemotherapy if its benefit is only 3%?

Regards,

Maddy

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Chemo therapy is as a standard advised when any lymph node is positive. This is because then the cancer cells are out in the body.

But how affected was that one lymph node. There is a difference in severity between "micrometastases" and "cancer cluster".

However she is ER positive, and in some countries, if there is strong ER positivity and less than 3 lymph nodes affected (there is only one), it may be cosidered to omit the chemo therapy, depending on a genomic test (which may show that you need chemo therapy anyway - it assesses the aggressiveness of the tumor relative to how suscepible it is to harmone therapy (its real ER positivity)).

You can get the test e.g. if you google "Oncotype DX" in India, but it is expensive. (And it may show that chemo therapy is necessary). There are a few competitors as well.

If you don't have the test, the general advice of any oncologist would be to have the chemo therapy. That percentage is misleading - the decision is the same all around the globe.

Kind regards,

Kaare (from Denmark)

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Thank you so much sir kaarenorgaard for clearing my doubts.

I have enquired about the Mammaprint test in India but its very expensive around 2 Lacs... :(

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MammaPrint, Prosigna (with PAM50), and Oncotype DX are the main competitors. And I know they are all expensive...

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Thank you kaarenorgaard sir for the information.

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Is it worth risking that your mother would be in the 3% or the 7%? If you are unsure of the doctor's advice, have your mother get a second opinion from someone else. I would certainly trust a doctor familiar with my case more than a software program!

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Very well and correctly said.

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Thank you MsLockYourPosts for the advice...I too agree with you rather a piece of software...

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Hi All,

Its just an update on my mother's ongoing treatment.. It might be helpful for someone..

I had taken a second opinion from most of the specialized Oncology Doctors in Delhi and everyone agrees with Dr. Sumeet, that to go for Chemotherapy in our case.

Our treating doctor suggested to go for 8 cycles which includes 4 cycles of AC and 4 cycles of TC. First cycle of AC has been completed. But after a week my mother's TLC dropped significantly to 1.7 range. Doctor suggested to admit her immediately as its a matter of worry. Doctor said it's a side effect of the Chemo as her body has not responded well. After staying for 3 days in hospital, her TLC has been increased to within the range. Her health is recovering now.

I'll keep the thread posted.

Thank you all.

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