Does my mom need chemoradiation second opinion for her cancer?
Patient's Query
Hi doctor,
My mother observed a lump in her right breast two months ago. The doctor advised a full abdomen USG, mammography, and FNAC. The results showed duct cell carcinoma (NST) with a lesion measuring 0.47 x 0.59 inches.
A surgical oncologist has advised surgical removal of a tumor (BCS surgery) followed by radiation and chemotherapy. He suggested that my mother undergo four to eight sessions of chemotherapy, depending on the biopsy report of the tumor.
I wish to seek a second opinion depending upon the requirement of chemotherapy and radiation therapies, and also want to know the possible side effects.
Kindly guide.
Hi,
Welcome to icliniq.com.
The current treatment for early breast cancer is breast conservation surgery and sentinel lymph node (axillary node) sampling. Please find out what modality is being planned to address the axilla, as not all patients need axillary clearance. After breast conservation surgery, radiotherapy is a standard treatment done over three weeks to reduce the risk of future recurrence.
Post-operative histology will dictate if your mother needs chemotherapy or not, guided by the grade, size, margins, and lymph node status. There are oncotype tests to personalize the treatment, which give the magnitude of benefit for a particular individual.
Radiotherapy is mainly given to reduce the risk of local recurrence. Side effects of radiation are skin reactions in the short term and hardening of the breast in the long term. I'm not sure whether your mother needs chemotherapy. If the nodes are negative with strong ER (estrogen receptors) in positive status, we could avoid chemotherapy altogether.
I hope this information helps you.
Feel free to reach out in case of further queries.
Thank you.
Patient's Query
Dear doctor,
In continuation of the above query, my mother underwent BCS. The biopsy and IHC reports of the tumor are attached for your kind reference. Her IHC report indicates ER & PR positive / HER2 Neu negative / Ki67 20%. The medical oncologist has advised six cycles of chemotherapy. The chemo drugs advised are also attached for your reference. Chemo shall be followed by RT and hormonal therapy.
Please advise if the treatment advised is good to go.
Hi,
Welcome back to icliniq.com.
I fully agree with the plan of action suggested to you. Radiotherapy and hormonal therapy are box standard here. On the role of chemotherapy, I would also advise chemotherapy in this instance, based on the grade and Ki67 score.
I hope this helps.
Thank you, and take care.
Regards.
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