Older Woman Age 78 Triple Positive Update
Sharing My Current Findings: Jan 2026
Age: 78, soon to be 79 next month,
Breast Cancer Confirmed:
- Location: Lower outer quadrant of the LEFT breast
- Size: 3.5 × 2.9 × 3.2 cm
- Nature: FDG-avid, heterogeneously enhancing, lobulated soft-tissue mass
- SUVmax: 8.83
- Local spread:
- Overlying skin: Not involved
- Underlying chest wall/muscles: Not involved
Lymph Node Involvement (CONFIRMED REGIONAL SPREAD)
- Left Axilla
- Level I–II lymph nodes involved
- Largest node: 2.2 × 2.7 cm
- FDG-avid, SUVmax 8.50
- Interpreted as metastatic
Brain Lesion**:
Non-FDG avid ill-defined enhancement is noted measuring approximately 1.2 × 1.2 cm.
In right occipital
Doctor/Oncologist Plan Recommendations
** No Surgery as of now:
STEP 0 — BASELINE CONFIRMATION (NOW)
Purpose: Safety + clarity before treatment
- MRI brain (clarify PET finding)
- Bone density scan (DEXA)
- Baseline blood work
- Cardiac function already acceptable
STEP 1 — START SYSTEMIC CONTROL (MONTH 0)
Treatment :
Before start: Get BONE DENSITY Check done to ensure all is well. (planning to take in 1-2 days)
- Letrozole (daily oral hormonal therapy)
What this step treats
- Breast tumor
- Axillary lymph nodes
STEP 2 — FIRST RESPONSE ASSESSMENT (AT ~3 MONTHS)
How response is measured
- Clinical breast exam
- Ultrasound of breast + axilla
- No routine PET at this stage
DECISION POINT A — BREAST + LYMPH NODE RESPONSE
Add HER2-targeted therapy
Comments
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Hi @nbhavsar and welcome to our community. We're so very sorry for the reasons that bring you here, but we're so glad you've found us. You're sure to find our amazing community a wonderful source of advice, information, encouragement, and support — we're all here for you!
It looks like you're still waiting for some answers before you get a treatment plan in place, including a brain MRI to ensure the lesion in your brain is not metastasis. We are sending good thoughts to you in the hopes of a clean scan.
Do you have any questions at this time that we can help answer?
Sending hugs!
—The Mods
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That sounds a LOT LIKE ME ! I have, or had Triple Positive Invasive Ductal Carcinoma in left breast, the mass was about 3mm and cancer in left arm pit. I had a double mastectomy and about 3 lymph nodes removed. Then I got an infection after the plastic surgeon placed tissue expanders and my chemo port. He had to take it all back out and wait for infection to heal. Now, I just finished my first round of chemo about four days ago. I will get 6 treatments, including the Paxman Cold Capping so I don't lose as much hair, I HOPE. Then I will get radiation, 2 other chemo drugs given IV for the rest of the YEAR and then hormone therapy pills for about 10 YEARS ! WOW ! I don't really get it, I am hoping all my cancer has been removed. I never knew this treatment would be so long and intense for breast cancer ! Anyway, I am doing okay. Just felt very tired and my muscles have been real sore off and on.
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Hi @cparnau ,
Thank you for reaching out. You are very brave, and I truly hope everything works out well for you. Stay strong.(Posting on behalf of my mother, nbhavsar, with her permission. I am her son, based in the U.S. My mother is in India, so I traveled here a few days ago to help take care of her.)
Treatment Update:
Our oncologist is taking a slightly different approach. One thing that pleasantly surprised me was how quickly we were able to complete multiple tests—ultrasound, biopsy, PET/CT, 2D echo, brain MRI, DEXA/BMD scan, and blood work—all within 6–7 days in a tier-2 city in India, and at a much lower cost compared to the U.S.
Our oncologist is currently recommending the following plan (we do plan to get a second opinion, and are meeting the doctor again tomorrow for confirmation):
First 3 Months:
- Start with Letrozole tablets (since the cancer is ER+ and PR+). As explained to us, lowering estrogen levels reduces the growth signal for ER/PR-positive cancer cells.
- He will review the bone density (DEXA) report before final confirmation.
- Since the cancer is HER2+, I need to confirm whether he plans to start HER2-targeted therapy (trastuzumab) in parallel. There are several cost-effective biosimilars available here in India.
- Expected outcome (per the oncologist): He is confident that the tumor should shrink by 40–50% within this period.
After the 3-Month Milestone:
- Re-evaluate and decide next steps—surgery or radiation therapy.
- I am personally cautious about radiation/chemotherapy given my mother’s age, but I am still learning and keeping an open mind.
Will continue to update as I learn more.
Wishing strength and healing to everyone here.0 -
I commend you on being such a good son and taking care of your mother. I am sure that she loves and appreciates you so much. I am also cautious about radiation/chemotherapy because there is no definitive on benefit vs risk and its obvious harmful nature. I am feeling side effects from chemo already and it does not feel natural to destroy my immune system. I hope it will be beneficial and the side effects are not that bad.
My prayers are with you and your mother
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