recurrence of cancer

My friends wife is 46 years old  pre - menopausal female known treated case of right breast cancer in 2002 gone for Modified Radical Mastectomy with three cycles of Chemo therapy (FEC) pre-operative & one cycle  of Chemo therapy post operative ( FEC)  and Four cycles of Taxotere with Herceptin 4 doses followed by Radiation. This was followed by Tab. Tamoxifen 20mg (1) for five years and Tab. Femora for further one year.

She had disease free period for six years.

She had symptoms of mild pain in chest therefore I have undergone PET-CT Scan to see the disease status. Report of PET-CT revealed Metabolically active multiple skeletal metastases. CT Scan revealed no visceral involvement at all. Right sided  minimal pleural effusion is seen ( Query H/O history of AKT after Chemo for skin lesions )

Please advice further line of treatment with recent studies and follow-ups based on following histopath reports after MRC :-

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

With Her2/neu oncoprotein positive
Intensity  2+
% Her2 / neu  positive  80

[Dennis MD]

Hi.
The PET-CT scan did not reveal any visceral metastasis, only bone metastases.  She will benefit with treatment with bisphosphonates.  This will relieve the bone pains she may be experiencing, as well as control the bone metastases.    
There may be a need to investigate further the cause of the minimal pleural effusion in the right lung.  This can be caused by both benign and malignant process.    
Hope this helps.