Patient's Query
Hi doctor,
I had pure mucinous right breast cancer and had a nipple-sparing mastectomy. Do I need radiotherapy? My report showed 0/18 free lymph nodes, free margins, ER 8/8, PR 8/8, HER2 zero and KI67 8 %.
Kindly help.
Hi,
Welcome to icliniq.com.
For cases involving mucinous and strongly hormone-positive tumors with no positive lymph nodes, adjuvant endocrine therapy is typically sufficient. Could you please provide information about the size of your tumor? This detail will help in providing more precise recommendations.
Regards.
Patient's Query
Hi doctor,
Thank you for the response.
Tumor size is 2.36 x 1.97 x 1.18 inches with an inadequate margin after excisional biopsy, which was done three months ago. After 15 days, I got a nipple sparing mastectomy with level 1 and 2 axillary lymph node dissection and Latissimus dorsi reconstruction.
The pathology revealed 0/18 free lymph nodes, free margins, ER 8/8, PR 8/8, HER2 0, and KI67 8 %. I started on Tamoxifen 10 mg, two tablets after dinner. I want to know if hormonal treatment is enough or if radiotherapy is necessary. I am afraid of the long-term side effects of radiotherapy. I have attached the pathology reports.
Kindly suggest.
Hi,
Welcome back to icliniq.com.
The tumor size was T3. However, based on present research, mucinous is a favorable histology and does not need radiation with node-negative status. I will stand by my point that it is important to continue endocrine therapy. I will strongly recommend continuing Tamoxifen.
As you are perimenopausal, you should get your FSH (follicle-stimulating hormone) and estradiol levels to see if you have reached menopause.
You should also be aware of the main side effects of Tamoxifen, which may include thromboembolic events, sweating, hot flushes, vaginal bleeding, elevated calcium, altered lipid profile, depression, body pain, muscle pain, and risk of endometrial cancer.
You should continue screening for other cancers like annual mammogram, cervical Pap smear, and baseline DEXA (optional) based on your risk of age-related osteoporosis.
Consider working on preventive health, including physical activity, nutrition, and weight management. You may take the recommended adult vaccination as per local guidelines. All the health recommendation for the general public also applies to you.
I hope this helps.
Feel free to reach out in case of any further queries.
Thank you.
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Answered byDr. Bharat Patodiya
Medically reviewed byiCliniq medical review team
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