Metastatic breast cancer stage IV spread only to bones

[Ajaydhand]

Hello.

My wife aged 38yrs diagnosed with breast cancer stage IV metastasis. Spread only to bones other organs are luckily untouched as of now. She ha ER & PR 90% +VE. HER2 NEGATIVE. She had 2 chemo cycles. Sm doc suggests to go for hormone therapy. Any suggestions please.

Regards

[Lisa-n-AZ]

I would recommended she get a second opinion. I am 52yrs ER/PR+ HER-, Diagnosed in Feb 2017, 6 liver tumors and 2 tumors in spine. I immediately completed 4 cycles of IV chemo then got a second opinion before starting 4 more cycles of IV chemo. I changed doc and started Ibrance and Letrozole. I have been NED (no evidence of disease) since August. Very happy with my decision to get second opinion, and DO NOT regret doing the 4 cycles of IV chemo before switching. I think for me starting IV immediately was good for my spirits.

We can do it we are strong.

Lisa

[Ajaydhand]

Thanks for sharing, Lisa.

Actually she is pre menopause.

[Boogitymom]

Have to agree with Lisa, get a second, even a third opinion. I’m 56, diagnosed in March 2016 with metastasis to the bone, most of my spine but also in femurs and pelvis, also er/pr positive, HER NEGATIVE. I’ve been on ibrance and letrozole since

being diagnosed. I’ve had very few side effects and there has been no progression, currently waiting for ct results. Very important to find a doctor you’re comfortable with and that will answer all your questions. I’d also suggest finding a support group.

Sending prayers your way

[theresac1 in reply to Boogitymom]

Are you on Bone Strengthening Meds? Zometa ?

[Boogitymom in reply to theresac1]

Yes, I get an xgeva injection every 4 weeks and 4000 units of vitamin D

[lynzer]

Hi there,

I'm 48 and was diagnosed in April with metastatic breast cancer. It's spread to bones, liver and I had multiple tumors up my spine and neck.

I'm Estrogen receptor positive, Progesterone receptor positive, and Her2 negative. ER+ and PR+ are the ones that benefit from hormonal therapy.

I first had radiation for 5 weeks to shrink the back tumors then chemo for 2 months. After that Ive been on Tamoxifen for 2 months and in 50% remission.

Since I was also premenopausal, I had to get luprin shots to go into menopause in order to star the hormone therapy.

I'm much happier just in hormone therapy. The chemo really had a bad effect on my health and state of mind.

Hope this info helps!

Lynn

[Cheza11]

Hello,

Pre-menapause does not exclude the use of iBrance.

I was diagnosed with Mets to the bone ER/PR+ in Feb 2017. For pre-menapause I was prescribed iBrance and Anastrozole. Additionally, for bone repair I do a monthly IV of Zomeda and take a 50,000 capsule of Vitamin D once a week. Every month my markers have gone down.

Find an oncologist you respect who works with you.

All my best-

[Ajaydhand]

Thanks everyone. Highly appreciate kind revert.

We had a second opinion and doc advised for hormone therapy.

But the present doc wants to go for few more cycles of chemo and feels that she is a potential candidate for surgery if all goes well. And then opt for hormone therapy. Believe this is a right way of approach.

Would appreciate if some more friends can join our forum and share..it feels good to be in touch.

Thanks and regards.

[Kats2]

Hi Ajaydhand,

I am ER+, PR-, and Her2-. When you’re ER+, the general rule is to use hormonal therapy to keep the BC stable. This is given in pill form, or if Faslodex is used, that’s given in shot form in the buttocks.

I don’t know what the initials VE stand for. Can you explain that?

I’m sure that hormonal therapy will be part of your wife’s treatment. Because of her young age, and the fact that she’s pre-menopausal, you probably should go to another facility and ask an Oncologist who deals strictly with BC to review her situation. It would be worth your while.

I hope your wife is getting a bone strengthener like Zometa or Xgeva, That’s very important and it’s helped me a lot, I get the Zometa infusions.

Good luck. Do your research and also seek more opinions from other Oncologists. Kats2

[MaryJ-S]

I don't know what "Sm" stands for but you need to get more information either from your wife's oncologist or get a second opinion. Some questions to ask:

1. Has the chemo she already had shrunk the lesions in her bones?

2. What Hormone therapy was the doctor thinking of?

A) Hormone therapy alone (Tomoxifin?)

B) Hormone therapy plus a CDK4/6 inhibitor?

C) Explain why he/she is choosing this treatment for you.

Best wishes,

Mary

[PJBinMI]

I too am a bit surprised that your wife was prescribed chemo at first with an E+ P+ her2neu- mbc and bone mets only. Often, chemo is only used for those of us with a hormone receptor positive mbc if an organ is failing, usually liver or lungs, as we generally do much better with hormonal treatment plus a bone drug like Zometa or Xgeva. I recommend she see a bc specialist onc for an opinion. If you are in the US, the top tier of cancer centers are those called "Comprehensive Cancer Centers." They are generally affiliated with a medical school and are listed by state on the website of the National Cancer Institute. They have oncs who treat only bc and do research, too, and are as up to date as it is possible to be! My insurance covered that with just the normal co pay for the onc visit, but my pathology slides and radiology films were all reviewed there by specialists, too. I was diagnosed in March, 2004 at age 58 and have been treated only with hormonals and the bone meds, plus a brief try on Ibrance. If you saw me, you would never guess that I have an advanced cancer. My long term plan does not include chemo. That could change. I hope your wife does well. Some of us with E + cancer and only bone mets are around the longest term survivors with mbc. So you have much to be hopeful about.

[Tera987]

Very good for chemo with bone Mets. This is where my first site was too. If they can keep it down and for as long as they can then you will not be out of the first and second protocol drugs for her oncotype. None of us are doctors so, definitely 2nd Oncologist opinions are best. But, chemo and hormones kept it out of another organ till my cancer cells morphed and new onocotype was changed after 5 years.

[Kats2]

Ajaydhand,

What is the exact type of breast cancer that your wife has? Is it ductal? Lobular? Inflammatory? Are there any other factors involved with this BC.? What Grade shows up on the Pathology report? The grade tells how aggressive the BC is. If it’s a high number it means that the cancer is more aggressive.

Also whether a woman is premenopausal or postmenopausal is another factor that the Oncologist takes into consideration. Some premenopausal women are encouraged to get their ovaries removed in order to reduce the amount of Estrogen circulating in their bodies. Cancer loves Estrogen if you’re Est+!

All these factors go into what type of treatment your wife gets. The Oncologist looks at the whole picture based on the Pathology report and makes his decisions based on this. It’s not a simple matter of whether your wife is Est+ or Her2-. So much more goes into selecting the proper treatments. There’s no “one type of treatment” for all women who even have similar subtypes such as ER+ Her2-.

For me I have Lobular BC with a Pleomorphic variant. This makes me a little more difficult to prescribe treatment for. I do NOT respond well to hormonal therapy even though I’m Est+ and Her2-. I also have only bone mets.

Much research is going on with Lobular BC and I was reading that IV Chemo may indeed be better for me along with other oral hormonal or chemo drugs. No one at this point knows for sure. It’s kind of a guessing game.

I plan on getting a blood biopsy ( liquid biopsy) in the near future to see it that’ll shed light on what drugs would be best for me to take. I had so little tissue from my tiny breast cancer that an Oncotype DX test was not able to be done on me. That test would tell whether I should have chemo or not. I didn’t. I had a lumpectomy and radiation afterwards. I believe that I had bone mets before I had my surgery, No one did any screening test like a bone scan to find out. I’m postmenopausal.

The bottom line is that BC is a complicated disease to deal with and treat. Each case is different. If you can, get as many other medical opinions on your wife’s treatment. She’s going to be monitored now for the rest of her life. She needs to have good decisions made.

Hope this has helped. Good luck and best wishes!

Kats2

[Ajaydhand]

Has anyone taking tablet Tamoxifen 20mg..

This is suggested by our Dr. after MRM surgery.

Appreciate revert.