reoccurent breast cancer

[melanieo]

May 1996 was diagnosed with right breast infilitrating ductal carcinoma incitu at age 32.  Initial biopsy - adenocarcinoma, infiltrating ductal type, size: 6mm diameter. Estrogen and progesteron receptor positive.  Had a mastectomy and pathology report read "no residual tumor identified."  Was not given any other treatment.  Almost 8 years later at age 40 on chest x-ray unrelated to any cancer worry found two nodules on left lung.  Biopsied the nodules and report finds one nodule 1.8 x 1.2 not adjacent to pulmonary vessels.  Second nodule 1.2 immediately posterior to the left atrium at the left aorta associated with blood vessels and appearance of one passing through. Both positive for malignant cells.  Adenocarcinoma most consistent with metastatic adenocarcinoma of breast origin.  Estrogen and Progesterone receptor positive, Her2Neu and CDX2 negative. Bone scan, PET scan, blood work all normal.  No symptoms.  Started Taxotere  onece every 3 weeks and xeloda 1300 mg daily for 2 weeks with one week off.   We were obviously surpised at this reoccurance because multiple doctors advised against any systemic treatment after first breast cancer and advised against taking out ovaries.  I guess I'm asking for your opinion about the chemotherapy and any other comments.  I plan on beating this and want to be as aggressive as I can.  I continue to exercise on a daily basis and have not had much interruption in my life.

[CCF-RN,MSN-rf]

Dear melanieo:  Although using chemotherapy in your situation with a 6mm tumor would have been controversial (the usual threshold for using chemotherapy is 1cm), I am a bit surprised that tamoxifen was not recommended.  Having said that, there are several options for chemotherapy with respect to recurrent disease.  Hopefully, this regimen will have a terrific result since the lesions are small.  You should also have a discussion with your oncologist about the future role of tamoxifen and/or hormone ablation.

[surgeon]

I'd also point out it's not impossible that the current disease could have arisen in your remaining breast: I assume you've had mammograms and exam.

[nurse12hr]

Your post struck a chord with me--I had almost the identical scenario at age 36.  I am now 46, and worry about late recurrence.  

I also did not have any other therapy.  I did try Tamoxifen but could not tolerate the excrutiating headaches I developed on it.  

I wish you the best in beating this.