Treatment for Metastasis breast cancer recurrence in bone

HISTORY OF MRS. RANJANA SURANA

1. Detected  Right Breast Cancer in 2002.

2. Treatment  was three cycles of Chemo therapy (FEC)

3. Modified Radical Mastectomy –

   a) Infiltrating duct carcinoma , grade 3 ( Nottingham modification of  
       bloom  Richardson grading system)
       - Associated DCIS with comedonecrosis, intermediate nuclear grade
    b) Nipple and surgical margins- free
    c) Axillary lymph node metastasis present (6/16)

        With Her2/neu oncoprotein positive
         Intensity  2+% Her2 / neu  positive  80
         T4, N1, M 0
         ER Weakly +tive  PR –tive, Her2 neu +ve

4. Post operative One Cycle of  FEC  and Four cycles of Taxotere with  
    Herceptin 4 doses only (Stopped Herceptin due to Port Complications )

5. Followed by Radiation.

6. This was followed by Tab. Tamoxifen 20mg (1) for five years and Tab.
     Femora for further one year (without Menopause).

7   Disease Free for six years.

8. In October 2008 she had  mild pain in chest therefore undergone CT Scan
    and thereafter PET Scan.

9. Report of PET-CT revealed Metabolically active multiple skeletal
    metastases. CT Scan revealed no visceral involvement. Right sided  
    minimal pleural effusion is seen ( Query H/O history of AKT after Chemo
     for skin lesions )

10. Histopath repeated on Paraffin Block for Her2 neu by Fish Method,
      which showed Her2 neu +ve



11. Thereafter the line of treatment was :

     a) Made menopausal with Zoladex till today.
     b) Aromycin 25mg per day
     c) Ibandronate 50mg per day.
     d) Xeloda 2500 mg per day with Tykerb 12500 mg per day of 21 days 3    
         Cycles
       (Stopped for one Cycle due to severe side effects)

12.) Repeated PET Scan on 27th January 2009. Reported that significant
       reduction in metabolic activity of skeletal lesions and resolution of
       Right Pleural Effusion.

13)  Repeated 3 Cycles of Xeloda 2000 mg per day with Tykerb 1250 mg
        per day

14) Thereafter, continued Tykerb 1250 mg per day only for 2 months and

15)  Repeated PET Scan on 24th June 2009. Reported that compared to the
       report of January 2009 there was marked regression in metabolic
       activity of all skeletal lesions except Right 7th Rib ( SUV MAX = 4.66,
        Previously 2.48 ). No evidence of metabolically active new lesions.

16)   Continued Tykerb 1000 mg per day only with Aromycin 25mg per day    
         and   Ibandronate 50mg per day to date.

[japdip]

I'm not sure as to what you are asking here. After reading the complete treatment history it seems that excellent medical care was given in this case. Metastatic cancer involving the bone is one of the more easily controlled types and many pt.s survive for years with proper treatment.   Kindest regards ....