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Doctor insights on: Triple K Breasts

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I had 1mm of invasive dcis and had lumpectomy, mastectomy and 13 nodes removed, tamoxifen. High estrodial, then bi.Ooph & arimidex (anastrozole) is it excessive?

I had 1mm of invasive dcis  and had lumpectomy, mastectomy and 13 nodes removed, tamoxifen. High estrodial, then bi.Ooph & arimidex (anastrozole) is it excessive?

NO : Lots of information missing , the results of the tests. If I have to guess had initial lumpectomy , later mastectomy was done most likely due to recurrence , ovaries removed to control skeletal metastasis, if it is true it is usual correct pathway to control aggressive tumor in 53 yr old , not true provide additional info, speak to oncologist , good luck if all neg , seek ii nd opinion. ...Read more

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32 YO, triple positive, grade 3, stage 1B breast cancer. TCH chemotherphy, had dbl mastectomy. What is survival rate?

32 YO, triple positive, grade 3, stage 1B breast cancer. TCH chemotherphy, had dbl mastectomy.  What is survival rate?

Need Clarification!: Are you sure your breast cancer was triple positive(or was it triple Negative)??? TCH is commonly used chemotherapy for triple negative, so please double check and let us know. Then we can give you survival figures. In general, small tumors(Stage 1 and stage 2) have very good survival rate and high cure rates. ...Read more

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Awaiting 6 month FU mammogram (cluster amorphous microcalcs L breast). L breast now abnormally larger than R, visible veins. Cud b cancer or hormonal?

Awaiting 6 month FU mammogram (cluster amorphous microcalcs L breast). L breast now abnormally larger than R, visible veins. Cud b cancer or hormonal?

Hormonal: microCa when more than 6-8 in tight region might represent DCIS but not invasive Ca which would show up for the most part as a lesion on mammo. Larger breast probably hormonal but visible veins might represent Mondors disease. This condition is a rare entity characterized by a sclerosing thrombophlebitis which might contribute to altered breast shape. ...Read more

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43 yo female 1.5 CM stage 1 breast ca, idc, er/pr+, node neg, lumpectomy with neg margins, no lvi, oncotype score 11. Chemo+rt+tamoxifen or no chemo?

43 yo female 1.5 CM stage 1 breast ca, idc, er/pr+, node neg, lumpectomy with neg margins, no lvi, oncotype score 11. Chemo+rt+tamoxifen or no chemo?

ARR - non-binary: Using adjvuant online! and making some assumptions for missing data: there is a 25% risk of relapse, tamoxifen absolute risk reduction (arr) is 9%, chemo arr 14%, combo (chemo+tam) is 18% arr. Combo-chemo is 18-14% is 4% absolute benefit from chemo. This low benefit is confirmed with oncotype DX recurrence score (low risk). So, the decision is non-binary, but rather about the arr benefit. ...Read more

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Idc breast 2.4cm, grade 3, N0, er+, pr+, hers-, 65 yr old. Will I need chemo? Will oncotype be high?

Idc breast 2.4cm, grade 3, N0, er+, pr+, hers-, 65 yr old.  Will I need chemo?  Will oncotype be high?

Your Cancer is not b: Your Cance ris not bad type. being ER+ means hormonal therapy will take care of your problem. The role of chemo is limited. Oncotype Dx test should be done in order to find out your risk for recurrence. That can address if chemo should be used also or not. ...Read more

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Vitamin d 20 ng/ml & nash. Vit a, e, k normal. Taking D3 for 2 months - no change. Can this be an absorption issue even tho other fat sol vits normal?

Vitamin d 20 ng/ml & nash. Vit a, e, k normal. Taking D3 for 2 months - no change. Can this be an absorption issue even tho other fat sol vits normal?

May need magnesium: Magnesium (mg) is a necessary co-factor for converting vitamin d into its active form. You may well be deficient in mg, and this can be tested via rbc magnesium. (serum mg is not so useful, since the body keeps this very stable, but your total body stores may still be deficient). http://tinyurl.com/msoth5j talk with your doctor about using magnesium glycinate to replenish this. It may help! ...Read more

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Due to childbirth & nursing, my breast size is now 38dd w marked ptosis. Would breast reduction or augmentation be appropriate for much needed "lift"?

Due to childbirth & nursing, my breast size is now 38dd w marked ptosis. Would breast reduction or augmentation be appropriate for much needed "lift"?

When to lift: In cosmetic breast surgery, we evaluate the size of the breasts as they match the patient's desire, the quality and fullness of the skin envelope, and the nipple position. Breast reduction will reduce the breast size, reshape the envelope and reposition the nipple. Breast lift will tighten the envelope and raise the nipple. Lift with augmentation is generally used to enlarge and raise the breast. ...Read more

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My age is 35 have high cholestrol & m planning to start GNC triple strength fish oil plus krill softgels or should I start GNC triple omega 3-6-9 soft?

My age is 35 have high cholestrol & m planning to start GNC triple strength fish oil plus krill softgels or should I start GNC triple omega 3-6-9 soft?

History: You should discuss your history and status with your physician. You may well need more effective treatment than fish oil to lower your risk profile for cardiovascular disease. ...Read more

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6y10m old daughter w/ 3 dark, thin, pubic hair. No breast, axilae, bo, no diff in genitals.Since baby, 95 percent height/weight, soy milk bc allergies?

6y10m old daughter w/ 3 dark, thin, pubic hair. No breast, axilae, bo, no diff in genitals.Since baby, 95 percent height/weight, soy milk bc allergies?

Early adrenarche : A bone age x-ray would be helpful to determine if further investigation is currently warranted. If she is overweight, that needs to be controlled because early pubic hair is often seen in overweight kids who may then develop early puberty. Any secondary sexual development prior to age 8 in a girl should be medically followed. Pediatric endocrinologists are often consulted. ...Read more

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Fe deficient rt heavy menses. 8wks IV Fe, hh&Fe study norm. 3mo later total Fe 28, TIBC 539, %Fe sat 5, ferritin 5. All worse than before IV Fe. Why?

Fe deficient rt heavy menses. 8wks IV Fe, hh&Fe study norm. 3mo later total Fe 28, TIBC 539, %Fe sat 5, ferritin 5. All worse than before IV Fe. Why?

Continuing blood: loss. A likely explanation for indicators of your iron store not improving is continuing blood loss. You should take oral iron supplement on an on-going basis. IV iron is indicated you cannot tolerate oral iron or are unable to absorb iron. For proper dose and preparation of oral iron, please consult your doctor. For good health - Have a diet rich in fresh vegetables, fruits, whole grains, milk and milk products, nuts, beans, legumes, lentils and small amounts of lean meats. Avoid saturated fats. Drink enough water daily, so that your urine is mostly colorless. Exercise at least 150 minutes/week and increase the intensity of exercise gradually. Do not use tobacco, alcohol, weed or street drugs in any form. Practice safe sex. Get HPV vaccine. ...Read more

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38 yo very strong FH breast ca, BRCA neg, Stage 2 IDC, 18 mo. s/p bilat radical mastectomy. No chemo. What is best f/u imaging/testing? Chemo?

38 yo very strong FH breast ca, BRCA neg, Stage 2 IDC, 18 mo. s/p bilat radical mastectomy. No chemo. What is best f/u imaging/testing?  Chemo?

Breast ca f/u: No follow-up imaging is indicated. History and physical is all that is required. imaging and blood test would be indicated if you were concerned for metastatic disease or a local recurrence. The additional of chemotherapy depends of pathologic stage including lymph node status, tumor biology and possibly the result of Oncotype testing. ...Read more

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5yo kid, Aug 15: Folic acid >20.0 ng, vit B12 of 725.0 pg, ser ferritin 20.20 ng, PTH 70.4 pg; vit D 59.11 in 5/15; folic acid, PTH, fer r they normal?

5yo kid, Aug 15: Folic acid >20.0 ng, vit B12 of 725.0 pg, ser ferritin 20.20 ng, PTH 70.4 pg; vit D 59.11 in 5/15; folic acid, PTH, fer r they normal?

Why tests done ?: What is wrong with the 5 years old boy.Why was all these tests done.his tests . All tests except parathyroid hormone are normal . Parathyroid is slightly elevated as normal is 15 to55 in 5 yrs old.You have to discuss with the doctor who ordered the tests and you know the reason you took 5 years old to doctor. What is doctor looking for. What is the calcium level .Discuss all that with the Pedia ...Read more

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I'm breast feeding can I take vit c 1g/ 5ml vit c ampule intravenously to improve my skin? I heard that certain amount of vit c goes to baby via milk?

I'm breast feeding can I take vit c 1g/ 5ml vit c ampule intravenously to improve my skin? I heard that certain amount of vit c goes to baby via milk?

Vitamin C for skin: Vitamin c is safe when breastfeeding. But for skin issues, topical vitamin c is more often used. http://tinyurl.com/mjowvh3 some doctors provide meyer's IV "cocktails" that contain vitamin c and other nutrients, but skin is not usually the main reason for this. ...Read more

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Right biceps brachii twitching for 36 hours. Cbc, b12, vit d, liver & renal, thryoid normal. Wbc slightly high.Vit k and magnesium not help.No strain?

Right biceps brachii twitching for 36 hours.  Cbc, b12, vit d, liver & renal, thryoid normal. Wbc slightly high.Vit k and magnesium not help.No strain?

Ignore it: It's fairly common for one muscle to under fasciculations for a few days. I suspect that is happening is that the nerve has taken a minor injury. Denervated neuromuscular junctions are sensitive to circulating acetylcholine and th muscle will twitch while the nerve is healing. This is how it was explained to me & it makes sense -- if persistent or progressive, get seen. ...Read more

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Fatigue, weight loss, Albumin 3.7, Total protein 7, Platelet 167, mchc 33, RDW 11.9 vitamin d 25. hx of ^ liver enzymes 1yr normal now.Causes Concern?

Fatigue, weight loss, Albumin 3.7, Total protein 7, Platelet 167, mchc 33, RDW 11.9 vitamin d 25. hx of ^ liver enzymes 1yr normal now.Causes Concern?

Need checkup: If your weight loss is unintentional, you need further evaluation. There are lots of reasons for your symptoms e.g. depression, thyroid issue or cancer. Please see a health care provider ...Read more