Is chemotherapy and radiation necessary

My sister was detected a tumour in her left breast size 1 cm x 3/4 cm - which was removed. Reports informed Invasive duct carcinoma

After that we had PET scan which gave the remark - NO EVIDENCE OF FDG AVID LESIONS TO SUGGEST METASTIC DISEASE.

One more test was done -

Estrogen Receptor - strongly positive in 80% of the tumour cells

Progesterone Receptor - strongly positive in 80% of the tumour cells

HER 2 - Score 1+ Result negative

Also undergone gland biopsy(lymph nodes) near the brest /underarms

Under severe tension what will be the further treatment - advising chemo and radiation - also one expert is informing only hormone therapy will be needed. Pl guide what will be suitable to avoid the recurrence & precaution. Can only hormone therapy be sufficient if lymph nodes biopsy comes negative

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  • I have a few questions:

    1. Was the whole breast removed, or only the tumour (lumpectomy)?

    2. Was an axillary clearance done?

    3. I would suggest a test called Ki67. Has this test been done?

    Your oncologist is the best person to advise, as he/she would know the complete details. We can guide you, though, if you could let us know the histopathology report in detail. If you wish, you can scan and send us the histopathology report on the emails proivded here:

    breastcancerindia.net/conta...

    Just one more thing, your sisters cancer is definitely in the first stage, this is very good. She can definitely expect to fall in the 'excellent survival' category. So I suggest to you, not to take tension at all. It's just that, plan the treatment properly. In cancer, the first hit is the best hit, and we cannot compromise there.

  • Dr Thanks. Only tumour was removed. Yes as per discussions with the Doctor what I collect the axillary clearance was done. Again yesterday one more report has come of the glands. Out of 3 - 2 shown positive. Dr is that the cancer has started spreading fast in the lymph nodes also. Which report I should send - PET scan or the initial - again yesterday one report has come of the glands tested.

    Sister had undergone one more surgery when the 2/3 lymph nodes were taken for biopsy last 3 days back only. Still the drain is continuing. A small jar under the arm is placed. The report which I have informed is positive for 2 glands out of 3. Is the treatement reqd very urgently or we should wait till the wound is healed. Our doctor is not available for 3 days more hence under tension

  • She will need a surgery again for a complete lymphatic clearance in her axilla (he minimum number of nodes for a reasonable axillary clearance is 10). It is very important, since 2 glands are already positive, and it has a bearing on her outcome. I guess, the second surgery she underwent must have been complete axillary clearance.

    This should be followed by chemotherapy, and followed by radiation (since this was a breast conservation surgery), followed by Hormonal therapy. Are the margins of lumpectomy clear?

    It's OK, if this takes a few days, since your doctor isn't there, don't worry. Once he comes back, she can undergo completion axillary clearance. And do not worry. Just ensure, you get the standard of treatment

  • Dr - only 3 glands were removed and not the all from her axilla. I will mail you the reports. It means again she will have to first undergo surgery and then chemo and radiation. For chemo how much settings will be reqd - she is very afraid of the side effects of both removal of nodes and chemo and radiation

  • Dr I have mailed the reports. Pl see and help

  • Hello Kontak

    I am a cancer survivour, Undergone treatment for 2yrs.Ask your sister not to afraid of chemo and radiation.side effects are less than the happiness,She will get after.being cancer free.

  • What was the stage of your cancer, whether the chemos & radiation painful

  • My cancer was of 3rd stage.I got 8 chemothrepy then surgery after that 26 radiation done.than transtuzimab tharepy yes side effects are there but you can manage it with will power,good diet and medication. .Trust your Oncologist and God.Don't worry she will be alright.

  • hello ma'am, how r u? my mom is undergoing her treatment right now. i would like to ask u whether a mastectomy was done in your case and how long did the complete healing process take. also whether your lymph nodes where removed? in my mom's case a mastectomy has been done n lymph nodes have been removed. prior to surgey she underwent 4 cycles of chemo n now another 4 cycles are to be given to her.

  • hello dear i m a cancer survivour please tell u r sister to keep thinking positive n ofcourse prayers they do wonders be strong keep u r mind occupied no negative thinking then mediciene will work better u have abetter life to look forword too

  • Very very well said, kalpana bakshi!

  • Trust your Oncologist fully and go ahead with the treatment.

    Once the chemo n radiation are over - regular check ups, good diet n regular exercise will keep you fit for life.

    Don't worry Be happy

    :)

  • Just afraid and tense. With the help of all your guidance and confidence - definitely will come out

  • kontak, please do not worry. We have good chemotherapy drugs, and with proper medications, one can overcome all side effects.

    I received your email, I will reply in detail there.

  • Dr axillary clearance has been done 3 days back. Having severe pain in the hand and shoulder. Drain is continuing - more than 100 ml per day. How much time it will continue. Though it has been informed that within a week time the drain will stop. But I want your guidance. Also when the chemo can be started - after the wound is completed healed? May be 20 to 25 days. The report is expected after 3 days.

  • 1. Start shoulder exercises, to maintain movement at shoulder. This will help reduce the pain.

    2. Drain usually reduces in 8 to 10 days. Occasionally, it may go on for more than a couple of weeks or more.

    3. Chemotherapy should be started by the end of 3rd week or beginning of 4th week, pot surgery (in any case, should be started within 6 weeks of surgery)

  • Thanks Dr. The further report has also come. Mailed you. Pl see and help

  • hello Shreyat

    i am doing well, thanks.My mastercomy was done and complete axillary clearance was done . it took about one month to heal than they started radiothrepy.Wish your Mom a very fast recovery.

  • My sister had lumpectomy and axilla clearance last 15 days back. All the lymph nodes were removed. Still after a gap of 2/3 days the drain is there. Planning to go for first chemo on 8th morning. She will have to go 6 cycles of chemo with a gap of 21 days. After that radiation and hormone therapy

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