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Do immunotherapy help in stage 4 breast cancer?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

The first case of cancer was a stage 3 ER+ invasive cancer of the left breast. Now, it is in stage IV invasive lobular carcinoma, with results of ER positive, PR positive, and HER2 with equivocal recurrent cancer. The site of disease is present on the abdominal lymph nodes and omentum with ascites and pleural effusions.

  1. Is the current treatment right?
  2. Are there any other tests recommended that help find more information?
  3. Any further recommendations required? Should we need to try clinical trials or immunotherapy?

Please help.

Thank you.
Answered by Dr. Kumar Varadarajan Senthil

Education:

MBBS

Professional Bio:

Dr. Kumar Varadarajan Senthil is a Medical Oncologist specializing in Radiation Oncology. He is an expert in advanced radiation therapy techniques such as IMRT, IGRT, and stereotactic radiosurgery. He does Multimodal cancer treatment planning in collaboration with surgical and medical oncology teams. He helps in the management of solid tumors, including lung, head and neck, breast, and prostate cancers. He can also give symptom control, palliative care, and quality-of-life improvement for cancer patients. He can do precision oncology and treatment personalization based on genetic and molecular profiling. He also does research in radiobiology and clinical trials for innovative cancer therapies.

This doctor is not available for online consultations on the platform anymore.

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Hi,

Welcome to icliniq.com.

I understand your concern.

I have gone through the attachment (attachment removed to protect patient identity). Yes, it is appropriate to use chemotherapy at this juncture. The HER2 (human epidermal growth factor receptor 2) result is mentioned as equivocal. So, please do a FISH test (fluorescence in situ hybridization) to find out whether it is positive or negative.

After chemotherapy, consider doing maintenance hormonal therapy. Immunotherapy in breast cancer is still in its infancy, and promising results are seen in triple-negative breast cancer. I will not suggest a clinical trial at this juncture.

I hope you find this helpful.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

I have a couple of follow-ups:

Yes, her FISH test reports are going to come in the next two weeks.

  1. Do you recommend genomic testing?
  2. Would you recommend we look for options for immunotherapy?
  3. Could you provide more details on why you do not recommend clinical trials at this point?

Kindly suggest.

Thank you.

Answered by Dr. Kumar Varadarajan Senthil

Education:

MBBS

Professional Bio:

Dr. Kumar Varadarajan Senthil is a Medical Oncologist specializing in Radiation Oncology. He is an expert in advanced radiation therapy techniques such as IMRT, IGRT, and stereotactic radiosurgery. He does Multimodal cancer treatment planning in collaboration with surgical and medical oncology teams. He helps in the management of solid tumors, including lung, head and neck, breast, and prostate cancers. He can also give symptom control, palliative care, and quality-of-life improvement for cancer patients. He can do precision oncology and treatment personalization based on genetic and molecular profiling. He also does research in radiobiology and clinical trials for innovative cancer therapies.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern.

1. Let us wait and see what FISH (fluorescence in situ hybridization) results show.

2. Genomic sequencing and testing are useful in adjuvant or curative settings to look at the efficacy of chemotherapy.

3. Immunotherapy is a new concept and has been explored in various cancers. To the best of my knowledge, triple-negative breast cancer is an area of promise.

4. There is no scientific backing for using immunotherapy in breast cancer in daily clinical practice for lobular carcinoma at this stage.

However, if you find ongoing trials, feel free to get enrolled.

I hope this helps.

Thank you.

Medically reviewed by iCliniq medical review team
Published At February 26, 2023
Reviewed At July 9, 2026

Education:

MBBS

Professional Bio:

Dr. Kumar Varadarajan Senthil is a Medical Oncologist specializing in Radiation Oncology. He is an expert in advanced radiation therapy techniques such as IMRT, IGRT, and stereotactic radiosurgery. He does Multimodal cancer treatment planning in collaboration with surgical and medical oncology teams. He helps in the management of solid tumors, including lung, head and neck, breast, and prostate cancers. He can also give symptom control, palliative care, and quality-of-life improvement for cancer patients. He can do precision oncology and treatment personalization based on genetic and molecular profiling. He also does research in radiobiology and clinical trials for innovative cancer therapies.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Kumar Varadarajan Senthil
Dr. Kumar Varadarajan Senthil

Radiation Oncology

Education:

MBBS

Professional Bio:

Dr. Kumar Varadarajan Senthil is a Medical Oncologist specializing in Radiation Oncology. He is an expert in advanced radiation therapy techniques such as IMRT, IGRT, and stereotactic radiosurgery. He does Multimodal cancer treatment planning in collaboration with surgical and medical oncology teams. He helps in the management of solid tumors, including lung, head and neck, breast, and prostate cancers. He can also give symptom control, palliative care, and quality-of-life improvement for cancer patients. He can do precision oncology and treatment personalization based on genetic and molecular profiling. He also does research in radiobiology and clinical trials for innovative cancer therapies.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality
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