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Operation in 4 stages

savaloko Member Posts: 30

Hi all. I know that they don’t do surgery at stage 4, but I know cases when surgeons took it and performed the operation. I don't see similar threads on this forum and would like to hear from you....

Have any of you had stage 4 surgeries? Maybe someone knows such cases?


  • olma61
    olma61 Member Posts: 1,025
    edited July 2023

    There is a thread titled "A Thread for Oligometastatic Folks" there are some people in there who have had surgery. Oligometastatic is someone with minimal metastatic disease, sometimes described as five or fewer metastatic sites or <5 lesions, depending on what you read.

    Also, some people if they respond well to treatment initially will be offered surgery or radiation that were told they could not get when first diagnosed.

    I haven't had surgery but I was able to get radiation to an active area in my spine after my scans started showing no metabolic activity elsewhere in the bones.

  • margaritams
    margaritams Member Posts: 183

    I had surgery at stage 4 and like Olma said, I was initially told that there was really no point to it since I had metastases in my liver, skin and spine. And my cancer is/was inflammatory, which is an aggressive and fast-spreading subtype. However, after a near complete response to treatment in my liver, skin and bones, my doctor suggested that a mastectomy probably made sense after all. Her reasoning was two-fold: 1) if I didn’t progress in the other sites, she didn’t want the remaining breast tumor (which had shrunk significantly but had not disappeared) to be the culprit for progression and 2) she felt that ultimately, lowering my overall tumor burden was a good idea whether or not I progressed in other areas. So yeah, I had a mastectomy without reconstruction (reconstruction was not recommended due to the fact that I had had skin mets on my breast). That was 8 years ago now and while I’ve had small progressions a number of times in my spine and muscles, my overall tumor burden has remained low and it’s never returned to the liver or the breast/skin area. No regrets here. Hope this helps.

  • savaloko
    savaloko Member Posts: 30
    edited July 2023

    My mom had a decaying breast tumor in 2019. There were metastases in the lungs.We were put on a combination of letrozole and ribociclib. In two years, all metastases in the lungs disappeared and the decay of the tumor in the mammary gland decreased.Why didn't they want to operate? I don't know.

    Today, they want to cancel Ribociclib and letrozole, because several metastases appeared in the lungs and the tumor again began to disintegrate and a bump formed on the rib outside.

    They want to transfer to Fulvestrantum and now they definitely don’t want to delete anything. We don't know what to do.....

    I am in favor of removing everything completely and doing chemo therapy and only then planting on Fulvestrantum.Doctors are against and want Fulvestrantum... But then there will be no protection....

  • dancemom
    dancemom Member Posts: 404

    De Novo Oligo here, and my team decided I get it ALL. Had mastectomy, radiation, on targeted and hormone therapy... The goal of surgery was to get rid of as much as possible, since the spread is only to sternum, then blast the sternum and internal mammary nodes, top it all off with targeted therapy. Dr's felt I am strong enough to be treated aggressively, especially as the mets are few and potentially, hopefully can be stopped from spreading more.🤞🤞🤞

    It's a balancing act of the side effects from all the various treatments and quality of life. Treatments are definitely hard on the body.

  • sondraf
    sondraf Member Posts: 1,605

    I had surgery when Ibrance failed at the local (breast and axilla) level and as everything else had responded and they wanted to get rid of the bulk of the tumor load, went for it. I also had immediate DIEP recon. In the right circumstances surgery can be used like radiation to manage local growth and prolong a treatment.

  • divinemrsm
    divinemrsm Member Posts: 6,098

    savaloko, not all stage four are turned away from surgery. I was diagnosed stage iv from the start in early 2011 with bone metastases in hip, rib and scapula. The breast tumor was about 2.5 inches by 1.5 inches (I do not grasp centimeter sizes). It was located in the six o clock position of the left breast, her2- / er+. My oncologist never told me I could not have surgery. What I did was have neoadjuvant chemo to see if the tumor would shrink, which it did, significantly. I then had a lumpectomy. Per my instructions, I did not have any lymph nodes removed. I saw no reason it was necessary and less cutting seemed the right thing.

    I was unfortunate to get a diagnosis of mbc, but have been one who’s responded well to numerous treatments. I would never say that it’s because I had surgery. Imo, it is simply that the cancer is not as aggressive as some others have. I struggle with the term ogliometastases. Imo, the idea offers false hope, and yet I would not say it’s never possible. Yes, some of us are living years with mbc, but we can’t necessarily say why. And at any time, mbc can rear its ugly head. Anyway, that’s my two cents worth!