Dr. Arshad Hussain Shah
Medical oncology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My mother was diagnosed with stage 1 DCIS, right breast cancer (ER and PR positive ) seven years ago, followed by radiation and eight cycles of chemotherapy. Unfortunately, there was a distant recurrence at the left breast with metastatic stage 4 grade 3 (ER and PR negative) of invasive ductal carcinoma after two years of the initial diagnosis.
The oncologist diagnosed and proceeded with radiation, eight cycles of chemotherapy (Paclitaxel), and a couple of cycles of Capecitabine. The medication Capecitabine has been stopped after multiple chemotherapies. She is taking Morphine 30 mg thrice a day and Buvalor ten patches for pain relief. She developed lymphedema on her right arm during this condition, which worsened after five months. Before two months, we noticed an open wound in the same arm, gradually increasing and affecting the entire upper arm and right chest. The lymphedema arm has open wounds and continuous water oozing from that region. I have attached the latest PET and CT scans for your reference.
Kindly give your suggestions about my mother's case.
Hi,
Welcome to icliniq.com.
I went through your query and understood your concern.
I have reviewed your mother's reports, and it looks like she has advanced breast cancer (attachment removed to protect the patient's identity). She has a huge local recurrence with bone, lung, and skin metastasis. She is also hormone receptor-negative which also is a poor prognostic factor. It is very difficult to cure at this stage, but she can benefit from palliative chemotherapy for disease control and relief from symptoms. She needs to undergo an MRI (magnetic resonance imaging) of the whole spine to rule out spinal cord compression. In addition, she needs painkillers, bone stabilizing agents, and regular dressing and cleaning of the lesion.
Regarding further chemotherapy, I need to know her previous details, like the type of chemotherapy she received seven years back. And it is difficult to comment and give suggestions without physically examining her and reviewing her radiological images.
I hope this was helpful.
Take care.
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