Doctor insights on:
Pet Breast Cancer Response To Treatment
Oct 2012-pet scan done with 2 areas of concern after breast cancer dx....Had biopsy and bone scan that were both neg...All cancer treatment done and #2 pet showed same areas-no change. Why bone scan?
D/w your MD: The best person to answer your question is your doctor. Have a discussion with your doctor and see what the reason is. Most likely is the same reason your doctor did the bone scan last time- to ensure that this is also unchanged on the bone scan. Unlike the bone scan, the pet scan was not done dedicated only to check the bone. What is your cancer marker, alkaline phosphatase level? D/w your md. ...Read more
Cancer is a group of diseases that is characterized by uncontrolled cell growth leading to invasion of surrounding tissues that spread to other parts of the body. Cancer can begin anywhere in the body and is usually related to one or more genetic mutations that allow normal cells to become malignant by interfering with internal cellular control mechanisms, such as programmed cell death or by preventing ...Read more
What is the best treatment for s tage 2a breast cancer in a 63 yo male. No nodes were positive and pet CT scan was negative. Er positive.?
Tamoxifen: After a mastectomy, use of tamoxifen in an er+ tumor has the best historical experience for this rare condition in men. The decision to use chemotherapy may depend on comparable metrics used for breast cancer in women such as size of tumor, grade, presence of markers (her2neu, high ki- 67). Though no data in men, oncotype DX theoretically can help with treatment decision about need for chemo. ...Read more
Do I need a pet scan after surviving breast cancer? I had breast cancer (stage 1) and treatment was successful. I just had a mammogram and there was no cancer. Treatments were chemotherapy and radiation.
You and your oncolog:
You and your oncologist need to discuss this. Given the low stage, and assuming successful completion of treatment, pet/ct might not be indicated at this time. It does depend on the specifics of your case.
Pet/ct is useful in evaluating for distal metastatic disease. It does not replace mammography, ultrasound or breast MRI for local recurrence surveillance ...Read more
Multimodal Rx: The primary treatment for most breast cancers is surgery, either mastectomy or lumpectomy; if one chooses lumpectomy, they will also require radiation therapy. Depending on the stage of the cancer, chemotherapy may be indicated. This may be given as a pill and/or IV medication, depending on tumor-specific factors. ...Read more
Everything: Depends on certain factors but typically includes surgery followed by chemo (or vice versa) and radiation therapy. If her-2 positive, trastuzumab (herceptin) is given for a year and if er or pr positive, hormone therapy is given for 5-10 years. Should be an orchestrated effort by specialists in different fields. ...Read more
Depends what stage..: ...And how healthy she is. Age by itself shouldn't be the factor that dictates her treatments. If it's an early stage cancer with good prognostic features, she may only need the lump removed with surgery +/- anti-hormone pill. She should hear about all her options from a team of specialists including surgeon, med onc, rad onc and pain/palliative care if she's not in good health. ...Read more
I've seen cases: Of what we call "neglected" breast cancer...And it is not pretty. The skin of the breast can dissolve, bleed, grow, and smell. It can leave deposits across the chest and back, and as it is destroying the breast and skin, cells can travel to brain, bones, liver. These women are miserable and sad...And hard to help. ...Read more
Gene testing: It will vary depending on the personalized genetic signature of the tumor. You need to know yours. I admire your courage in asking. Best wishes. ...Read more
Over the last few decades many things have changed:
Taxanes as part of the chemo plan is established for lymph node-positive disease.
Herceptin was approved for Her2+ breast cancer.
Pertuzumab was approved for Her2+ breast cancer when given before surgery. Lumpectomy and radiation are alternative to mastectomy in many patients. Radiation is more focused, allowing less toxicity. ...Read more
Yes: I advise my breast cancer patients to begin treatment within 1 month of diagnosis. The first line of therapy is usually surgery, which will also provide the necessary information to stage the cancer; this information is used to guide further therapy, such as radiation- and/or chemotherapy. On occasion, I advise chemotherapy first to shrink the tumor to facilitate a lump-x rather than mast-x. ...Read more
Chemo, xrt, hormones: Usually includes chemo, radiation and hormone treatment. ...Read more
Dependent on details: There's variability in the aggressiveness of cancers. Size matters too, even if lymph nodes are negative. Hormonal receptor status and other prognostic features help in the treatment planning. Breast conservation requires radiation treatment for most. Chemo may not be helpful, but best to follow through with consultations, no matter how early it was caught. Your surgeon should guide you. ...Read more
Yes: Each person can decide what treatment they would want, or if no treatment is wanted. You would need to be fully informed of the risks of treatment or no treatment. Untreated cancers grow, and spread. Neglected breast cancers can turn into open bleeding skin ulcers, spread to lung or bones, etc. ...Read more
I have finished treatment for stages 3 breast cancer. How often should I be tested to ensure the cancer hasn't returned?
Follow up important: Talk to your oncologist. I tend to see patients every 3 months for physical and labs. Sooner if any concern arises. ...Read more
Herceptin (trastuzumab): The local treatment option (breast conservation versus mastectomy) are the same. The diff comes with systemic therapy. Her2+ cancers are more aggressive but this is counteracted by the biological (antibody) herceptin (trastuzumab). This is generally given with chemo. Since this is the case, it may often given before surgery (neoadj) to gain additional prognostic info and shrink the primary. ...Read more
Breast cancer tx: During a breast cancer treatment, you would work closely with your oncology team- including a breast surgeon, medical oncologist and radiation oncologist. All of them will work with you so you can get the best therapy available tailored to your case and to ensure that you can get through the therapy well, cope with those possible adverse events and still able to maintain descent quality of life. ...Read more
Not for any cancer: There is no homeopathic "treatment" that has any effect on breast cancer nor on any other cancer. A person may feel better after taking a homeopathic "medication" either because he truly believes the "medication" is helpful, and so he is happier and uplifted; or because he is just by coincidence feeling good that day. ...Read more
Variable: Breast cancer is individually treated depending on each person's condition, cancer stage & cell type. Surgery (lumpectomy) often combined with the proper chemotherapy or hormone agents, and sometimes radiation therapy. It varies highly from one person to another, depending on the factors I have noted above. An oncologist can help direct you for your personal care. ...Read more
Depends on details: Stage at diagnosis (tumor size, lymph nodes involved, is it early stage, etc.), biological factors (Her-2 +/-, gene profile -OncotypeDX), your age and health and your understanding of benefit/risk of treatment options and other factors all are considered in decision making. List can be: surgery, radiation, anti-estrogen pills, chemo- & biological therapies, bone building drugs and clinical trials ...Read more
Ask an oncologist: Most patients with breast cancer which is er/pr positive will benefit from adjuvant hormonal treatment. Please realize that we cannot offer specific treatment on this site. It would be best for you to have an oncology evaluation and follow her/his recommendations. ...Read more
Probably: You MUST have your 2 Drs coordinate with each other. You MUST discuss this with both Drs. ...Read more
Occurs when glandular cells lining the milk ducts and lobules of the human breast begin to grow in an unregulated manner. Often curable if found early and treated effectively with surgery, hormonal therapy, chemotherapy and targeted therapy, or a combination thereof. Early detection before the malignancy becomes large enough to be felt depends on mammography/sonography and MRI imaging of the breast ...Read more
Most breast cancers are carcinomas. This is a type of breast cancer. These cancers start in the cells that line organs and tissues. In fact, breast cancers are often a type of carcinoma called adenocarcinoma, which starts in cells that make glands (glandular tissue). Breast adenocarcinomas start in the ducts (the milk ducts) or ...Read more