Masectomy op complete. What is the correct course of treatment now ?
Hi
I`m writing on behalf of my mother but who has recently had a masectomy of the left breast in the last 3 weeks. This was the report we asked for on breakdown:-
Multifocal infiltrative ductal carcinoma, Grade 2 with DCIS high grader
3 Tumours max diameter 28mm+8mm+3.5mm.
Margins clear, minimal 3mm medial and 20mm inferior
ER/PGR positive. Her-2 negative.
No vascular invasion
Auxillary nodes 0/3.
She has a complicated medical past no ops but always had quite a weak immune system and picks things up really easily. 62 years old with no history of breast cancer in family. Medical history is currently taking Simvastatin 40mg, for high cholestoral, Ventilin occasionaly, asthmatic. Had double neumonia when young in 20s. Still prone to bronchtis.So I`m very concerned about her having even a non invasive form of chemo afterwards which has been recommended. Alternatively Anastrazole/Arimidex has been suggested as an alternative to the chemo but they say could still come back within 18 months without chemo.
She is having a full body scan at the Imperial College in London shortly to check for any other cells before she makes a decision on treatment. She went there for a second opinion and was again offered chemo but a new type of treatment involving a new procedure using 3rd generation chemo that is suppose to have a 98% success rate which has been developed in the US but not yet approved for general use here in the UK. She has been given a 68% chance with no treatment at all.
Does anyone have any advice on what still be to follow up with chemo or oestrogen inhibitor even if no cells are found in the body from the scan ?
How long can you leave it if no cells beore you can have chemotherapy if you have to take it ?
Many thanks for any replies
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Thank you for your question, and it is great that your mom is receiving a second opinion so that she is aware of all of her options. I have read about the great success rate of 3rd generation chemo treatments, and hope it will be approved in the UK soon!
I have forwarded your question to one of our experts, and hope we will hear back from them soon. Please keep up updated on your mother's condition, as well as her full body scan, while we wait for our expert's response.
The largest tumor may need examination through an Onco Type DX -- a gene analytical test of the actual tumor itself that helps to predict the benefits of chemotherapy plus anti hormone therapy vs. anti hormone therapy alone. It helps to predict the benefit of chemo in your mother's situation.
For more on the test, visit genomichealth.com.
Also, the full body scan that's going to be done at the Imperial College of London can only detect macroscopic disease, meaning the disease that's 2 to 3 mm or greater in size. It cannot detect microscopic disease.
Yes, your mom does need to have her whole body treated. The minimal therapy would be the anti-estrogen and the maximum therapy would be the anti-estrogen and chemo together.
Thanks again for both your replies.
The Onco Type DX test looks superb but as it has been some time since the operation I don't think they would have kept the actual tumour tissue ? We are asking tonight just in case.
I cannot find much literature on the web regarding 3rd Gen Chemo treatment. Just looking for additional information. Are there any sources that you know of ?
I found a few articles related to breast cancer, but please note the dates, as many of them are more than 5 years old and may no longer be relevant. You can read the journal articles that your doctors are reading, to see some of the clinical lingo in writing, and perhaps your doctor can let you know if there are any updated clinical research studies published in the medical journals that you may read. (Accessible at university and public libraries).
My source is PubMed for published clinical and medical research (again, it is difficult to read unless you have a medical degree, but you can get a general idea of what the research topic is, and what they concluded from the study...may create some good questions for you to speak with your doctor about):
- Current Trends in Pharmacotherapy of Breast Cancer (2002)
- The Evolution of Primary Chemo in Breast Cancer (2004)
- Ovarian Carcinoma & Chemo Treatment (2009)
- Radiation and Third-Generation Chemotherapy (2004)
- Effectiveness of Third-Generation Chemothearpy and Lung Cancer (2009)
- Third Generation Chemotherapy and Lung Cancer (2002)
- Annals of Internal Medicine: High-Dose Chemotherapy in Breast Cancer (1996)
Thanks Alison
The only survey report I could find on the effectiveness of Post-surgery chemotherapy questioned for certain breast cancer patients is on the following link and makes for very interesting reading. Only downside is it's now 7 years old and the success rate of 3rd gen chemo has obviously increased since then.
http://www.dana-farber.org/abo/news/press/071602.asp