Second time around needing Chemo - just wondering about the prescribed treatment
Double mastectomy 7 years ago. New 1-2 cm cancerous lump found on breast and also in three sentinel nodes have all been removed. Same cancer (EST+, HER2- ). Having more surgery next week to remove 1st and 2nd level nodes. After surgery, my oncologist is prescribing Doxorubicin and Cyclophosphamide every two weeks for 4 weeks, then Paclitaxel once a week for 12 weeks. Then radiation for 4-5 weeks.
Looking these up online and they seem very aggressive. Is there any other options?
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So sorry you're going through this. That protocol is pretty standard for a high risk cancer, which I'm guessing your pathology and/or Oncotype shows. Some centers would do the Paclitaxel every two weeks for a total of eight treatments, which is one month shorter, but I think a higher dose. Even with mastectomy, radiation would likely be recommended now for you given nodal status.
Of course, get a second opinion if you're uncomfortable. I know that is a lot to face.
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Hi there, 2x survivor here too. I'm sorry you're going through this again, for me it felt like lightning striking twice. Our situations aren't the same - you can see my history in my signature - but I did doxorubicin (and cytoxan) and paclitaxel both times. Agree with ratherbesailing, no harm in getting a second opinion even if it's just for peace of mind. You can also ask for review by the tumor board. Good luck with the node surgery! Keep us posted.
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@crossh - We’re so sorry you’re facing this recurrence and such a difficult treatment plan. Please know you’re not alone. As you can see, this community is here for you, and we’ll be here to support you.
We’re sending strength as you prepare for surgery and treatment ahead.
Sincerely,
The Mods
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Just an update, got a second opinion from a new surgeon and oncologist today and it’s completely different. Apparently there’s a newer PET scan that works better for estrogen positive cancers. FES PET-CT (Fluoroestradiol Positron Emission Tomography-Computed Tomography) is a nuclear medicine imaging technique used to detect and assess estrogen receptor (ER)-positive breast cancer.
Apparently my first oncologist didn’t think this was necessary. I’ve decided to take a breath from this train ride and have this test. The outcome could change the treatment dramatically. If more cancer is found in other areas, there’s no reason for the additional lymph node removal. If no more cancer is found, there are options other than chemo. My lymph nodes that were positive never showed up on the original PET scan. So I never felt confident in the results. I will be switching to this new oncologist for any future treatments.
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Thanks for this update! ANYTIME the results of a test could change the plan, the test is worth doing (in my opinion). I'm glad you have another onc and hope for clearer answers. Keep us posted please!
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I'm so glad to know about this PET scan as it may be an option for me. I was diagnosed 5yr ago with Stage II HER2-, ER,+ bc in my right breast. I elected for a lumpectomy over a mastectomy. The surgery was successful; both the tumor site margins and lymph node margins were clear. The tumor board recommended that based on the pathology and my age (I was 70) I only needed immunotherapy. I took Femara for 5yr - finished in July. All of my exams and mammograms had been normal. I had a mammogram in August that reported an "asymmetry" in my right breast. I just had the biopsy, and I'm devastated. I don't have the results yet, but I'm not hopeful.
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Best of luck to you. Hopefully it’s nothing. It really is devastating when you think you’ve beat it and it comes back. I’m having my PET scan FES tomorrow afternoon and have canceled my Friday lymph node removal surgery, for now. I’ve also notified my oncologist of my decision to leave her practice. Hoping this new PET scan comes back clean. 🤞
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Welcome @gizziesmom to our community!
We're so sorry you find yourself here, but we're glad you found us. You're sure to find our community a wonderful source of advice, information, encouragement, and support — we're all here for you!
For you, and all here, there's some good information on FES PET scans on our site — this type of PET scan is typically used for invasive lobular carcinomas (as opposed to invasive ductal carcinomas) since that type of breast cancer can be very hard to see on trational (FDG) PET scans. Read more here:
We hope this helps!
—The Mods
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I originally had the FDG PET scan and it showed nothing in the three nodes that were taken out when re-excising for a clean margin. They all were positive for cancer, one had even spread outside the node. Hoping that the FES will be more accurate.
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Results from PET FES shows cancer in all three levels of Axillary lymph nodes. So depressing. Everything else looks clean. Not sure what’s next.
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We reviewed them the following day. Now waiting for surgery to be scheduled to remove all three levels and also have LVA. She was very upbeat about it, happy that it stopped there.
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