Dr. sivanath
Internal Medicine
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Patient's Query
Hi doctor,
My mother, who is 55 years old, is undergoing chemotherapy for breast cancer T4 M1 (less than 5 mm non-avid in lymph node above lung) Nx, after mastectomy. She is HER2 positive and other two receptors are also positive. We have two different opinions in front of us from the two best oncologists here. The first opinion from our current oncologist is FAC 3 cycles (already given), Daxotel (3 cycles and second one is going on) and then to continue with Herceptin. The second opinion from another senior oncologist is that since she is HER2 is positive, the above regimen of the FAC and Daxotel is useless. She needs to start chemotherapy all over again with 6 cycles of Abraxane along with Herceptin. Otherwise, metastatic cells will spread soon to brain. The second opinion hit us and gave a big shock. She has just finished the task of chemotherapy and we hear that the drugs used were useless. I am here to know the reality of above and to seek an advice of which route we should take. Please help us.
Hi,
Welcome to icliniq.com.
I understand your plight.
Your mother seems to be in stage 4 and less likely 3. However, to give the benefit of doubt, I think that people has considered to give chemotherapy followed by response evaluation. If the result is favorable, then they may even opt for surgery (variable). In stage 4 hormone positive, we prefer to give the only antihormonal agent. In her case, anti HER2 therapy has to be added as she is positive for it. I will not suggest the second type of chemotherapy at this time if there is no obvious progression.
In my opinion you should continue with third dose and see the response on radio imaging. We may plan to continue anti HER2 with hormonal agents, while keeping her on close follow up. In less often scenario, if the response is phenomenal, then we may plan surgery. But, this will need further discussion. Do not worry, she should do well.
For further information consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist
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Internal Medicine
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