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Topic: Ca 27-29 Tumor Markers increasing

Forum: Stage II Breast Cancer — Meet, share and support others with Stage II Breast Cancer

Posted on: Sep 28, 2020 09:54PM

Kath1228 wrote:

I am freaking out! My oncologist does tumors markers as part of my regular bloodwork every 6 months or so. I have always been in a range of 12.5 to 17.5 on my CA 27-29 for the last 6 years. But my numbers have been increasing over the last 4 times (about a year and a half) from 13.6 to 20.6 on September 14. It jumped from 17.6 to the 20.6 number in just 4 months.

I know this is well within “normal” limits, with 38 being considered the upper range of normal. But it is not normal for ME!! I had to draw my oncologist’s attention to this upward trend and now she is having my bloodwork repeated on October 19th because of the trend. I am so terrified something is going on.

She did ask me how I was feeling the day I had my bloodwork done and I wasn’t feeling great and have been extremely stressed. I had a cold and/or very bad allergies - lots of nasal congestion and just not feeling great. It wasn’t COVID...I got tested because I was feeling so crummy.

My doctor said inflamed mucus membranes could throw the results off....but then I later spoke to her NP who then contradicted her and said that’s not true!!! What?! I was holding onto that as some hope....


Has anyone had an upward trend that was due to something other than your cancer returning...I am so nervous and frightened that I can barely function....and still have to wait three weeks for bloodwork. Just when I started making some plans in my life...selling our home and buying a new one...I feel like I tempted fate by making plans....


My CEA markers are fine and all other bloodwork CBC, CMP are totally normal. WBC was a little high for me 9.3 - but maybe I was fighting off an infection at the time....I need some hope that there could be some other reason for this increase in CA27-29....🙏🙏

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Sep 28, 2020 10:34PM MinusTwo wrote:

Kath - before I ever had CA27-29 test #1, my MO made sure I knew that this is just an indication. My numbers every six months since 2014 go from 20 to 35, with an average of 25. Yes, it if keeps going up for some time, they look closer. I did get feed back the two times mine was 33 & 35 that it could be affected by a lot of things, including infection and maybe even stress. At one point I had a UTI and had not started antibiotics yet. It went down once that was resolved.

I'd listen to the doc & not the NP for now. And of course try not to panic. Fingers crossed. Please do come back & let us know.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Sep 28, 2020 10:41PM Kath1228 wrote:

Hello MinusTwo - thank you for that! I will try and stay hopeful that it was just due to that fact I wasn’t feeling well that particular day and pray the number goes back down to normal for me. I appreciate you replying!!

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Sep 29, 2020 02:47PM MinusTwo wrote:

Kath - holding you in my thoughts. Please do update when you can.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Sep 29, 2020 03:06PM Kath1228 wrote:

I certainly will...thank you.🙏

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Sep 29, 2020 03:36PM - edited Sep 30, 2020 01:56PM by SpecialK

kath - my CA27/29 is regularly tested even at 10 years out, my oncologist believes in tracking. One of the reasons some don't though is because of what you are experiencing now - your number is bouncing around, although still within the accepted normal range, which is creating anxiety for you. There are a number of factors that can influence markets, particularly inflammation. My initial markers were in the 20's at diagnosis, but rose to the mid 60's as chemo ended. They did not return to the normal range for months. I have had several instances where they have again risen up and out of the range - always due to inflammatory process. Try not to worry, and I'm hoping that your oncologist is willing to re-test to provide you peace of mind, not because of the potential for an issue.

BMX w/ TE 11/1/10, ALND 12/6/10. 15 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 6/18/13-present. Dx 9/27/2010, DCIS, Stage 0, Grade 3 Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC)
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Sep 29, 2020 03:49PM Kath1228 wrote:

Thank you SpecialK!! (My friends call me SpecialK too!!😊) This means a lot. Trying to hang on to some hope and positivity and hearing others experiences certainly helps!! I am being re-tested on October 19th....a long wait!!

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Sep 29, 2020 04:48PM - edited Sep 29, 2020 04:55PM by sbelizabeth

Kath1228, my previous onc followed tumor markers every visit. I even put together an excel spreadsheet and graph for myself, so I could see trends at a glance.

Even when I was first diagnosed, my markers were normal, and although they have bounced all over the place throughout the years, they've always been in the normal range. When tumor markers rise to indicate a possibility of a recurrence, they rise way above the normal range and keep rising. There's a post from a woman with metastatic disease whose treatment is working well: "In less than 2 months my CA 15-3 has gone from 1320 to 206."

I don't know exactly what the nurse practitioner meant, but yes, inflammation and illness can very much influence tumor markers. My onc wouldn't draw them when I was recently post-op, and she said the stress of chemo could also make them rise. The numbers you describe aren't a "jump," they're almost certainly just a normal variation for you.

Follow-up according to your onc's orders, track the trends, pay attention to your body for new aches or pains or symptoms, but don't let a rise of 3 points destroy your peace.

pinkribbonandwheels.wordpress.... Dx 10/20/2011, IDC/IBC, Left, 1cm, Stage IIIA, Grade 2, 6/28 nodes, ER+/PR+, HER2- Chemotherapy 12/15/2011 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/18/2012 Mastectomy: Left Radiation Therapy 5/21/2012 Breast, Lymph nodes Hormonal Therapy 7/19/2012 Femara (letrozole) Surgery 4/15/2013 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Sep 29, 2020 05:05PM Kath1228 wrote:

Thank you for sharing your experience sbelizabeth! It certainly is comforting to know others have been told that illness/inflammation can have an effect. I guess my main concern has come from the fact that the numbers have risen the last four times (Since March 2019) - usually they go up and down...not always up....and the 20.6 number is the highest it’s ever been in 6 years...but I wasn’t feeling well the day they were drawn...so I’m hoping it was due to some inflammatory process...thank you again!!

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Sep 29, 2020 08:26PM MinusTwo wrote:

Kath - if you use Excel, you might want to make a spread sheet. Like sbelizabeth, I also made spread sheets of the blood tests I wanted to track.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Sep 29, 2020 08:31PM Kath1228 wrote:

MinusTwo - yes, I do use excel....it’s the last four data points I’m not liking...straight up....😞😞

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Sep 29, 2020 08:51PM - edited Sep 29, 2020 08:52PM by KBL

Kath, I am Stage IV. I had tumor markers done in 2016 because they thought I had a different kind of cancer. They were all in the 70s and 80s. They didn't think anything of it and didn't say it was anything to worry about. I was then diagnosed de novo Stage IV last year in May. My 27-29 was at 491. During this past year, my numbers have gone up and down, and my 27-29 is down to 318. I can tell you I had a UTI, and they checked not long after I was done with treatment, and it jumped up about 50 points. I had a feeling it was because of the infection, and the next month it came right back down.

I realize I am where you don't ever want to be, but I want you to know I don't panic when my numbers are moving around. I have told myself they must jump significantly over four times for me to think treatment has stopped working.

I have CEA, 15-3, and 27-29 tested every month. They are all quite a bit above normal. I'm actually kind of stuck in the high 200 and 300 ranges and between 6.0 and 7.0 on the CEA. I'm still on my first line of treatment.

I do base things a lot on how I'm feeling. Even CT scans and PET scans don't show my cancer, only biopsies and MRIs.

I hope you can find the reason they are going up, but if you're feeling good and all your other bloodwork is good, I would count on that.

De Novo ILC - No primary found. Mets to full spine, femurs, skull, and stomach. Dx 5/1/2019, ILC, Stage IV, metastasized to bone/other, ER+/PR+, HER2- (FISH) Hormonal Therapy 6/24/2019 Femara (letrozole) Targeted Therapy 6/24/2019 Ibrance (palbociclib)
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Sep 29, 2020 09:00PM Kath1228 wrote:

Hi KBL,

Thank you so much for the words of encouragement. I am seeing reason to be optimistic from all the wonderful ladies on this forum. I do wish you the very best and hope your treatment will be successful for a long time to come.

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Sep 29, 2020 11:22PM KBL wrote:

Kath, I’m so glad you feel encouraged. I know it’s so scary when something changes. I hope you keep this post going and let us know how you’re doing. I will add it to my favorites.

De Novo ILC - No primary found. Mets to full spine, femurs, skull, and stomach. Dx 5/1/2019, ILC, Stage IV, metastasized to bone/other, ER+/PR+, HER2- (FISH) Hormonal Therapy 6/24/2019 Femara (letrozole) Targeted Therapy 6/24/2019 Ibrance (palbociclib)
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Sep 30, 2020 08:41AM sbelizabeth wrote:

In 2014 and 2015, for my three-month 27.29, here's what the numbers did: 25...26...28...32...34. I noticed they were slowly creeping up, and I asked my onc about it. She firmly reassured me that as long as the results were in the normal range, all was well. Sure enough, the next one was 23, and three months later, 27.

KBL, thanks for sharing your perspective. It helps to know that when these markers indicate progression, they don't just go up, they go WAY up.

pinkribbonandwheels.wordpress.... Dx 10/20/2011, IDC/IBC, Left, 1cm, Stage IIIA, Grade 2, 6/28 nodes, ER+/PR+, HER2- Chemotherapy 12/15/2011 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/18/2012 Mastectomy: Left Radiation Therapy 5/21/2012 Breast, Lymph nodes Hormonal Therapy 7/19/2012 Femara (letrozole) Surgery 4/15/2013 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Sep 30, 2020 01:56PM KBL wrote:

For me they did. I can’t say it’s that way for everyone. I also have lobular, so that could be different as well.

De Novo ILC - No primary found. Mets to full spine, femurs, skull, and stomach. Dx 5/1/2019, ILC, Stage IV, metastasized to bone/other, ER+/PR+, HER2- (FISH) Hormonal Therapy 6/24/2019 Femara (letrozole) Targeted Therapy 6/24/2019 Ibrance (palbociclib)
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Oct 13, 2020 07:31PM Kath1228 wrote:

Just a quick update...I went to my ENT on 10/2 because I hadn’t been feeling well since early September (my bloodwork was done 9/14) - turns out I have a MRSA sinus infection! (I’m prone to sinus infections due to allergies) So I am hoping that is what pushed my markers up this time....I’m on doxycycline now...for three more days. Due to have my bloodwork redone on Monday 10/19...I think I’ll push it off for a bit until I’m sure the infection has cleared up and antibiotics are out of my system. Due to go back to the ENT on 10/21...so I’ll probably schedule for sometime after that...🙏🙏

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Oct 14, 2020 08:52PM sbelizabeth wrote:

MRSA sinus infection! How did they diagnose it? Did they do a swab for a culture? Sinus infections are notoriously difficult to wipe out with antibiotics, and MRSA is a persistent bug. Ask your ENT how they can assure it's 100% treated. From what I've read, a lot of people need IV antibiotics.

pinkribbonandwheels.wordpress.... Dx 10/20/2011, IDC/IBC, Left, 1cm, Stage IIIA, Grade 2, 6/28 nodes, ER+/PR+, HER2- Chemotherapy 12/15/2011 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/18/2012 Mastectomy: Left Radiation Therapy 5/21/2012 Breast, Lymph nodes Hormonal Therapy 7/19/2012 Femara (letrozole) Surgery 4/15/2013 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Oct 14, 2020 09:11PM Kath1228 wrote:

Hi sbelizabeth,

Yes, it was diagnosed with a culture. The doctor feels the doxycycline should knock it out and also doing an antibiotic nasal rinse...so hopefully that will clear it up🙏🏻🙏🏻🤞

I hope!!

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Nov 11, 2020 10:31PM Kath1228 wrote:

I am back with an update as promised! Had my CA27-29 retested on Monday after waiting for my sinus infection to clear up and antibiotics to get out of my system...and my number came down from 20.6 to 17.8! Back to a much more normal number for me (in the teens) - thank goodness!! Thank you to all of you for your supportive and caring words - very much appreciated.

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Dec 2, 2020 07:13PM HeatherPsalm34-4 wrote:

I’m so glad that I found this thread!!! My CA 27 29 tends to range in the 20s, but this time went from 27.7 to 32.6....made me start to get anxious....I know it’s still in normal range, but....argghhhh....this thread really encouraged me! I have an upper GI next week because there is some thickening/inflammation in my esophagus which of course is concerning (HOPING it’s nothing serious 🤦🏻♀️) Im curios if the inflammation and stress could have caused the raise...

Dx 6/2018, IDC, Left, 3cm, Grade 2, 5/8 nodes, ER+/PR+, HER2- Surgery 8/2/2018 Lymph node removal: Left; Mastectomy: Left Chemotherapy 9/13/2018 AC + T (Taxol) Radiation Therapy Lymph nodes, Chest wall Hormonal Therapy
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Dec 2, 2020 08:48PM Kath1228 wrote:

Hi Heather,

I’d say based on my recent experience that inflammation can definitely be a cause for markers to go up...I think stress comes into play as well because stress causes inflammation in our bodies also...hoping that’s all this is for you! 🙏🏻

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Dec 3, 2020 12:57AM sbelizabeth wrote:

Kath1228, did you get your sinus infection all taken care of?

pinkribbonandwheels.wordpress.... Dx 10/20/2011, IDC/IBC, Left, 1cm, Stage IIIA, Grade 2, 6/28 nodes, ER+/PR+, HER2- Chemotherapy 12/15/2011 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/18/2012 Mastectomy: Left Radiation Therapy 5/21/2012 Breast, Lymph nodes Hormonal Therapy 7/19/2012 Femara (letrozole) Surgery 4/15/2013 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Dec 4, 2020 10:33AM Kath1228 wrote:

Hi sbelizabeth,

Yes, I believe so!! But I always feel like I’m on the verge of another sinus infection with my allergies...my doctor says I’m allergic to Florida!! I am seeing my ENT today to look into starting allergy shots....☹️

Then right after coming off the antibiotics for the sinus infection, about two weeks later I get a UTI!! Started on Bactrim for that for 5 days...didn’t work...so now finishing up 10 days of amoxicillin....that’s a lot of antibiotics....ugh....

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Dec 4, 2020 10:45AM Spookiesmom wrote:

Don’t know where you are in FloriDuh, west coast is showing signs of red tide around Clearwater. Could be your irritation.

Reoccurrence 3-19. Dx IDC, Stage IIIA, Grade 3
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Dec 4, 2020 10:51AM Kath1228 wrote:

I’m in Palm Beach county...I’m very allergic to grass, mold, dust, palm tree pollen - so, allergic to Florida!! 🤪🤪

Never had allergies when I lived in Manhattan- go figure!

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Dec 4, 2020 11:02AM sbelizabeth wrote:

With the effects of 9 years of letrozole on my lady bits, I was getting a UTI every time I rode my mountain bike, a that's a lot of UTIs. The bugs seemed to just ignore Bactrim. Cipro can win the war in my bladder but the potential side effects of tendon rupture worries me. So now I have a little ceremony before a bike ride that includes a good pee and squirting the lady bits with a dilute Hibiclens solution. It seems to help.

Breast cancer, the gift that keeps on giving.

pinkribbonandwheels.wordpress.... Dx 10/20/2011, IDC/IBC, Left, 1cm, Stage IIIA, Grade 2, 6/28 nodes, ER+/PR+, HER2- Chemotherapy 12/15/2011 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/18/2012 Mastectomy: Left Radiation Therapy 5/21/2012 Breast, Lymph nodes Hormonal Therapy 7/19/2012 Femara (letrozole) Surgery 4/15/2013 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Dec 4, 2020 11:06AM Kath1228 wrote:

Yes, they wanted to give me cipro and I refused...it’s got too many potentially serious side effects....good to know about the Hibiclens!

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)
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Dec 4, 2020 11:14AM SpecialK wrote:

kath - I am also in Florida on the west coast, but my allergies developed in California. I did ten years of shots for all the same things you listed and my allergies now are pretty mild, managed with OTC meds like Claritin or Zyrtec. My testing pretty much showed a reaction to anything with chlorophyll, and all were pegged at the highest reaction level. Hopefully you can get a handle on managing with desensitization and it likely won't take long to see a difference. My situation was complicated by many military moves so I eventually abandoned shots since my environment, and allergens, were changing too often. I did need drug and cosmetic testing done about 20 years ago after persistent rashes and that revealed some interesting newly developed allergies to pine sap, sawdust, some essential oils, more than a few drugs, the surfactant (lathering agent) in all shampoo, soap, detergent, and some plastics components. I had to change shampoo immediately and get new glasses - I was actually allergic to the frames! It was valuable info during my breast cancer treatment as some of these new allergies were antibiotic and adhesive issues - necessitated alternate irrigation choices during surgery, limited post-surgical antibiotic choices, and forced my plastic surgeon to come up with a different bandaging plan. My husband jokes that soon I will be living in a bubble. My allergy derm said that new allergies can develop each decade when I asked him why this happened when it did - I think those of us with allergy issues are somewhat destined to have new and continuing sensitivities.

BMX w/ TE 11/1/10, ALND 12/6/10. 15 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 6/18/13-present. Dx 9/27/2010, DCIS, Stage 0, Grade 3 Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC)
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Dec 8, 2020 10:58AM Stillhavehope wrote:

my tumor markers went from 33 to 38. Is this a reason for concern? Till now they have gone down each time. My MO said that they are stable????

Dx 5/14/2014, IDC, Right, 5cm, Stage IIIA, metastasized to other, Grade 1, 5/13 nodes, ER+/PR+, HER2- Dx 6/2020, Stage IV, metastasized to other, ER-/PR-, HER2-
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Dec 8, 2020 11:50AM Kath1228 wrote:

Based on my recent experience, I would say not a reason to worry...especially if it’s just one upward reading...and not an upward trend over several readings...best wishes!

Dx 11/7/2013, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/4/2013 Lumpectomy: Left Radiation Therapy 1/22/2014 Whole-breast: Breast Hormonal Therapy 11/3/2014 Femara (letrozole)

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