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Topic: Recurrence of Breast cancer /Liver Biopsy question

Forum: Just Diagnosed With a Recurrence or Metastasis —

Meet others who are just facing the diagnosis of a recurrence of breast cancer or metastatic (advanced) disease. You are NOT alone.

Posted on: Apr 11, 2019 12:59AM

NicoleRod wrote:

So as some of you know I was diagnosed with a recurrence this Feb 2019. First time was Stage 0 2014 inSITU lumpectomy, radiation, no tamoxifen.

Feb 2019 now Stage II Double mastectomy onco score 49 suggested chemo. Went for scans today. CT of Chest and Abdomen and Bone scan. Hips (which were hurting were ok) but they found 2 spots on liver that they say is suggestive of metastasis. They want a needle biopsy. They had scans of my liver from 2014 and 2018 that showed I had previously had an angioma> spelling group of blood vessels nothing big. So they knew this was big and apparently looks like a metastasis to them, enough so that they do not even want a different scan to compare. I was pretty upset today. So I make this as to the point as possible.

I posted this here because A. Its a recurrence my breast cancer (the forum title says diagnosed with recurrence, so if this is in the wrong place please let me know.) and B. I wondered if anyone can tell me what the CT needle biopsy is like?? My doctor said she doesn't believe they put you to sleep for it. My friend had one on the kidney and she said it was extremely painful and she has kidney stones regularly and has a high tolerance for pain. So If anyone knows what I can expect I would appreciate it.

Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019 Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019
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Apr 11, 2019 05:19AM - edited Apr 11, 2019 06:02AM by Wildplaces

Hi Nicole,

I am very sorry to read this post - but my saying that, does not begin to cover it.

A liver biopsy In Australia is done under conscious sedation and local anaesthesia. It can be uncomfortable but should not be painful. In this context it is tough emotionally ( if ever an understatement) - please get the premed you need and ask for additional sedation as/if you require it.

From the operator/radiology point of view - they image concomittantly with the biopsy - and have to get adequate tissue from the lesions - here the more good bites - the stronger the pathology analysis. So yes it helps if you can hold/be comfortable throughout the procedure, please get/ask for the sedation you need before they start. A pathologist can only comment on what theyhave under a microscope.

Many ladies on the liver thread have had liver biopsies.

Nicole, two lesions are unusual but you will not know exactly what you are dealing with until they do the biopsy. There are a number of benign lesions that show up on scans.

( kidney biopsies tend to be more painful than liver - its the approach)

(())




Dx 8/5/2016, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/13 nodes, ER+/PR+, HER2- Surgery 8/11/2016 Lymph node removal: Underarm/Axillary; Mastectomy: Left; Prophylactic ovary removal Chemotherapy 9/11/2016 AC + T (Taxol) Radiation Therapy 2/20/2017 External: Lymph nodes, Chest wall Hormonal Therapy Arimidex (anastrozole)
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Apr 11, 2019 10:16AM NicoleRod wrote:

Thank you wildplaces. While you made me feel so much better just seeing someone replied, and also reading it's not so much painful as uncomfortable...I am scared now about the "it's unusual to have 2 spots". Sigh.

I don't know where the liver thread is I will try to find it.

thank you.

Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019 Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019
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Apr 11, 2019 10:28AM - edited Apr 11, 2019 10:30AM by Rosie24

I had a liver biopsy with ultrasound in January. It was not painful at all and I was awake but somewhat sedated. Doc said they may need to people to take some deep breaths to get best access so they want you awake. (Maybe that was just in my case, I don't know?) I got a calming drug first which was great, then the twilight anasthesia kicked in. I was aware but very relaxed. Good luck to you

Dx 1/23/2019, DCIS/IDC, Left, 3cm, Stage IV, metastasized to liver/lungs, Grade 3, ER+/PR-, HER2- (FISH) Targeted Therapy 1/24/2019 Ibrance (palbociclib) Hormonal Therapy 1/24/2019 Femara (letrozole)
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Apr 11, 2019 10:29AM NicoleRod wrote:

Thats a relief thanks.

Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019 Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019
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Apr 11, 2019 10:36AM Rosie24 wrote:

Nicole, I just want to add that the whole process is upsetting! I hope your results are good, but I definitely know the stomach sinking feeling when you’re told there’s something that needs to be checked out. Sending you positive vibes

Dx 1/23/2019, DCIS/IDC, Left, 3cm, Stage IV, metastasized to liver/lungs, Grade 3, ER+/PR-, HER2- (FISH) Targeted Therapy 1/24/2019 Ibrance (palbociclib) Hormonal Therapy 1/24/2019 Femara (letrozole)
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Apr 11, 2019 11:53AM NicoleRod wrote:

*with tears* thank you Rosie. Im not gonna lie. Im struggling here :( So thank you for "getting that"

Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019 Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019
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Apr 11, 2019 07:24PM Wildplaces wrote:

Nicole

The liver thread is " How are people with liver mets doing?" its stage 4 only and maybe not that useful until you know what you are dealing with.

I am genuinely sorry about the unusual comment. It was not off the cuff but clearly not what you needed to hear.

What I was hoping to get across was you need to do what you have to do so for the time of the biopsy you are able to hold, deep breathe and function so they can get adequate and plenty of samples.

Please know that I hate scans, avoid them, have been known to miss them because I hate them...rebooked.

It might pay to ask whether besides histopathology they are sending samples for genetic testing ( Foundation 1 and Carris seem to be the ones in US) - so if this is a recurrence they have some idea oftreatable mutations ( that is still in its infancy, not always essential but may provide additional information). This is a question that only your oncologist can answer.

I have seen your post on chemo. Nicole - the answer is yes and no. Sensitivity to opiods - pain meds is usually opiod receptor mediated so it does not mean you will necessarily have chemo issues. Sensivity to other drugs may be related to your size and dose or liver metabolic capacity. And there is the allergy spectrum. If you let the oncolgy team know and are specific in what you reacted to - so make a clear list ( drug and reaction) - they will adjust your dose over time appropiatley so you will still be able to do your treatment, they will send you home with meds to treat side effects, and you might want to ask for pre chemo hydration - may help.

Nicole - you have figured out by now that I am practical and direct - when I had my stage 2 diagnosis I took my practical butt to my local doctor - and asked for sleeping tablets - I could just do the days but needed sleep. We women are so strong all the time....

Hugs

Dx 8/5/2016, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/13 nodes, ER+/PR+, HER2- Surgery 8/11/2016 Lymph node removal: Underarm/Axillary; Mastectomy: Left; Prophylactic ovary removal Chemotherapy 9/11/2016 AC + T (Taxol) Radiation Therapy 2/20/2017 External: Lymph nodes, Chest wall Hormonal Therapy Arimidex (anastrozole)
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Apr 11, 2019 07:47PM NicoleRod wrote:

Awww thanks Wildplaces I like your tips about chemo. It's so weird how I was debating chemo (with all the problems I might have incurred.) I kept praying for God to help me make the right decision...and then I get his with this liver thing...now I am like give me all of it. .... I did find out they will give me twilight for the biopsy so lucky i will be a little out of it. Thanks for your well wishes :)

Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019 Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019
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Apr 12, 2019 02:35AM Meow13 wrote:

The one medication that helped me get through the panic was lorazepam. I took it for about 6 weeks till I knew what I was dealing with. I would suggest something like that while getting the liver biopsy and results. Good luck hope you get good news soon.

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Apr 12, 2019 09:37PM NicoleRod wrote:

The biopsy went smooth they numbed me and I didn't take any twilight. I am a little sore now. Had an long talk with the Radiologist (who was so great) without saying too much here..basically yea...it's looking like cancer. The biopsy report will be back next week. He did tell me that the location of the 2 spots are near the edges and I asked if they were areas that are operable and he said yes, they are not in what is considered an inoperable area. The thing that concerns me is that I think it may be aggressive like my breast cancer because I had a CT a year ago and those weren't there. Thank you all for the advice on the biopsy you all really helped.

I am very down right now lots of tears with my husband and just trying to process all this and I literally know NOTHING about liver, Cancer there or treatment or anything so next week I will very much need to rely on this site and the kindness of the ladies here.

(((((hugs))))))

Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019 Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019
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Apr 13, 2019 12:51AM Beesy_The_Other_One wrote:

Hugs back to you, Nicole. We're with you, and praying. ❤️

Beesy

1997: Phyllodes, R breast. 2018: IDC, L breast. TCHP, BMX, Radiation, Nerlynx coming. Dx 8/20/2018, IDC, Left, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
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Apr 13, 2019 09:56AM Rosie24 wrote:

Nicole, glad your biopsy wasn’t too rough on you. Try to keep an open mind until you get the report back. I think it’s good to brace yourself but there’s still a possibility it’s not cancer until you get the report. Also, your team may or may not suggest surgery on your liver. Waiting and worrying are the worst, sorry you’re in limbo.
Dx 1/23/2019, DCIS/IDC, Left, 3cm, Stage IV, metastasized to liver/lungs, Grade 3, ER+/PR-, HER2- (FISH) Targeted Therapy 1/24/2019 Ibrance (palbociclib) Hormonal Therapy 1/24/2019 Femara (letrozole)
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Apr 13, 2019 06:14PM NicoleRod wrote:

Thank you Beesy! Thank you Rosie. Ya know I know worrying is the worst and I almost felt relief when she spoke honestly to me about it. I am a Marine wife and like many women but especially those of us married to military men we like to prepare!!!! This is probably because we have to move every 3 years and sometimes sooner and unexpectedly. I do feel a little like "ok what do I need to do". We are getting the biopsy results hopefully by Thursday and I need them to take with me because we have made the decision to go to where our son and fiancee are, also my mom and nephew, niece etc. Which is to Long Island. I plan to get treatment at Memorial Slone Kettering. I was debating between there and MD Anderson but while I do feel that MD probably is slightly better, what little family we have is there in NY so my husband thinks it would be best to be there for treatment. I want to post and ask soooooo many questions about this but I know people want you to have the actual biopsy report before that so I am trying to wait. I just pray I can get some positive feed back on there and encouragement. Even thought I have the most amazing husband I sometimes feel so alone in this and I feel like only the women here can really "get It" . Thank you again ((((hugs))))

Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019 Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019
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Apr 13, 2019 07:29PM Wildplaces wrote:

Nicole,

I will pm you

Dx 8/5/2016, DCIS/IDC, Left, 4cm, Stage IIB, Grade 2, 1/13 nodes, ER+/PR+, HER2- Surgery 8/11/2016 Lymph node removal: Underarm/Axillary; Mastectomy: Left; Prophylactic ovary removal Chemotherapy 9/11/2016 AC + T (Taxol) Radiation Therapy 2/20/2017 External: Lymph nodes, Chest wall Hormonal Therapy Arimidex (anastrozole)
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Apr 15, 2019 02:17AM Monl wrote:

Hi Nic,

I read about your liver biopt. Fingers crossed all will turn out well. I had 3 spots on my liver as well-they saw on CT scan. A biopt isn’t done quickly here (netherlands) and since I have a tissue expander I can’t go into an mri to get a better image of my liver(magnet inside). So july first i get my diep flap surgery and after that I finally know more.

It is a scary rollercoaster all the time. And i can imagine the waiting is making you nervous. Thinking of you and keep us posted!

Monique

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Apr 15, 2019 02:19AM NicoleRod wrote:

Thank you Moni. We are pretty certain it is cancer but of course praying for a miracle! At least this way I feel kind of prepared for that news. Thank you for you kind post.

Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019 Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/30/2019
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Apr 15, 2019 08:30AM Monl wrote:

I pray with you. Stay strong

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Apr 15, 2019 09:13AM KBeee wrote:

My local friend had extensive liver mets about a year after finishing chemo. She was on Ibrance and now on Verzenio and it has been stable for a while now. There are definitely options, and it sounds like you can seek treatment at a place that is well known. Do not hesitate to get a few different opinions lined up, and ask why they recommend what they do, and how they'll monitor things. Even if you decide to cancel an appointment or 2, it is important to feel confident in the plan and the MO. Sicne it can take a bit to get in sometimes, best to call now and get an appointment on your calendar...and theirs.

Karen. Dx 8/5/2013, IDC, Right, 1cm, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC) Surgery 8/26/2013 Mastectomy: Left, Right Chemotherapy 9/20/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/12/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 1/23/2014 Reconstruction (left); Reconstruction (right) Surgery 1/29/2015 Lumpectomy: Right Dx 2/2/2015, IDC, Right, 1cm, Grade 2, 0/0 nodes, ER+/PR-, HER2- (FISH) Dx 2/25/2015, IDC, Right, 1cm, Grade 3, 0/13 nodes, ER+/PR-, HER2- (IHC) Surgery 2/25/2015 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary; Prophylactic ovary removal Chemotherapy 3/31/2015 AC + T (Taxol) Radiation Therapy 8/25/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Femara (letrozole)
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May 8, 2019 09:34AM LJDH0709 wrote:

I have a question regarding recurrence. I was diagnosed with a recurrence on the mastectomy scar line one year ago.

My question is if you do have a recurrence is the breast cancer generally thought of as a chronic condition (which is what I recently heard when watching a  panel of doctors discuss this in a video), and simply in  remission when the cancer has been treated/surgically removed?

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May 8, 2019 07:10PM KBeee wrote:

When it is metastatic, it is thought of as chronic, but local recurrences generally are considered curable (but who knows if we are ever truly cured). I also think terminology as far as remission, etc varies place to place.

Karen. Dx 8/5/2013, IDC, Right, 1cm, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC) Surgery 8/26/2013 Mastectomy: Left, Right Chemotherapy 9/20/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/12/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 1/23/2014 Reconstruction (left); Reconstruction (right) Surgery 1/29/2015 Lumpectomy: Right Dx 2/2/2015, IDC, Right, 1cm, Grade 2, 0/0 nodes, ER+/PR-, HER2- (FISH) Dx 2/25/2015, IDC, Right, 1cm, Grade 3, 0/13 nodes, ER+/PR-, HER2- (IHC) Surgery 2/25/2015 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary; Prophylactic ovary removal Chemotherapy 3/31/2015 AC + T (Taxol) Radiation Therapy 8/25/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Femara (letrozole)
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May 9, 2019 06:58AM LJDH0709 wrote:

I see, I guess sometimes some of these terms are used interchangeably.

Yes, regarding recurrence and cure, having been through a recurrence and now on tamoxifen, it looks as if the stats for me show that at some point in time it is very likely 

 that it will return instead of being cured forever.  .I guess its just a wait and see what happens situation.

thank you Karen

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