A case of post Case of BCT left breast with lung and bone metastases

[nikki_aud]

1 of 2
Dear Doctor,

My mom had a case of post BCT left breast with lung and bone metastases.

She had breast cancer 4 years ago and it was gone. Everything seemed normal afterwards (with no CT scan suggested from her doctor)

Since November last year she felt a pain between her chest so she went to see the same doctor.
After X-ray, the doctor found that her lung was damp. and took the fluid out to test for cancer cells.
the result was positive.

The next Monday she had chemotherapy.
She went through 3 times of chemo: Avastin & Docetaxol
Then afterwards, she had CT scan & Bone scan, and found that only some of the cancer cells were reduced.
but there were new cancer cell in her lower rib (at the spot they took the fluid out to test)
However, the doctor said it was no big deal & insisted on using Avastin & Docetaxol for the next 2 times.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Your mother had "triple negative" breast cancer. This means that all three receptors (ER, PR, HER2Neu) that are commonly tested in breast cancer patients turned out to be negative in her case. This triple negative pattern is associated with a more aggresive type of tumor and worse prognosis.
In metastatic breast cancer, the combination of a taxane (like docetaxel) and the monoclonal antibody bevacizumab (Avastin) is commonly used. The chemo is continued until disease progression or intolerable adverse effects.
Communication between the doctor and the patient (and family members and other care givers) is very essential for planning and delivering treatment. Please try to ensure that you are able to get an appointment for discussing all issues and clearing your doubts, fears, questions, and suggestions.
All the best, and God Bless!

[Kamal S Saini, MD, MRCP (UK), DM]

Hi Nikki,
Thank you for your kind words of appreciation.
Liposomal doxorubicin is effective in many women with metastatic breast cancer. I hope your mother is one of them.
All the very best, and be strong!

[nikki_aud]

Thank you so much for your kind support. It is a very hard time for all of us here, and we hope to have the strength to get over the situation. Right now, doctor changed the chemo to Lipo-Dox, and will continue with it for a while. Avastin and Docetaxel do not work well for her. Right now doctor found that the cancer spread to her right lung already (which did not appear in the passed 6 month).

Anyway, Thank you again for your information and suggestion and goodwill. I will pass it to my mom, and wish all the best for you and your team, your family, and all love one.

Best
nikki_aud

[nikki_aud]

Thank you so much for your king support. And here is the answers to your question:

What was the size of tumor at that time?
> around 1.5 cm

What was the stage? What was the ER, PR, and HER2Neu status?
> The doctor said it was stage 1 almost 2 (?) So I would assume that it was 2.
> Actaully at that time the doctor did not mention anything about the type of cancer, but from the current case, he said it is 'Triple Negative'

What other treatment did she get after the surgery?
> At the time, my mom had Chemo and radiology treatment.

I will try my best to get the correct answer to you, and hope this will help. But if you need more information, I would go check with the doctor again.

Best..God Bless

nikki_aud

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
I am sorry to hear about your mothers advanced cancer.
Your mother had breast conserving surgery 4 years ago. What was the size of tumor at that time? What was the stage? What was the ER, PR, and HER2Neu status? What other treatment did she get after the surgery?
Please let me know these details, and we can discuss further.
All the best, and God Bless!

[nikki_aud]

2 of 2
After the 4th chemo, she started to get bad pain at the same lower rib.
It got worse and worse so she insisted with the doctor on getting another bone scan.

Finally he changed from Avastin & Docetaxol to Lipo-Dox

Lately she went through many tests to prepare for radiology treatment (Total of 5 times, she had her first yesterday).
and found that there is pleural effusion in her left lung and that the pain in her chest might be due to
the fact that the cancer had spread to the lymph node (between her chest)

The questions are:
1.Since we are so clueless and have no personal connection with any doctor that we can talk to at all.
We have a feeling that this doctor is not treating her right but not sure.
Do you think this is the general case where the doctor has given the best care for the patient
but the decease just advance anyway?
Or is it possible that if the doctor had detected and listened to my mom's symptoms more carefully,
we could have actually stopped the cancer cell and saved more time on the treatment.
2. Do you have any suggestions on what we should do with her case?

Thank you very much for your help.

nikki_aud

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
I am unable to read the second part of your post (you mentioned 1 of 2). Pl re-load it.
Thanks.