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Jun 16, 2008 10:28AM
Jun 16, 2008 10:29AM
Yes, the trend right now for followup is no scans in the absence of symptoms as far as looking for mets goes. I disagree with the line of reasoning that it doesn't make any difference when the mets are diagnosed, but that's the NCCN and ACS guidelines right now. So unless you have an old school onc who scans annually no matter what, that's the standard of care right now.
As far as local recurrences go, however, most oncs are doing annual MRIs for ILC patients, even though we're not considered high-risk for a new primary like a BRCA woman is (again, I don't agree with this line of reasoning, and apparently most oncs don't either, thankfully).
I'm getting annual mammos and MRIs. The onc wants one or the other every six months; the surgeon wants them done annually at same the time (she said it's easier to biopsy something seen on MRI if you have a corresponding mammo to look at). So I'm not sure what kind of schedule I'll be on for sure yet.
But one thing the surgeon mentioned when I saw her last week was to wait a year after rads to have an MRI, b/c otherwise the MRI would light up like crazy with all sorts of radiation changes.
Another thing is, my rad onc did a mammo on the "bad" boob before radiation to get a baseline.
As far as ovarian mets go, from what I've read, it's very hard to find them--sort of the same problem the docs have in early detection of primary ovarian cancer. I do know that vaginal u/s is a good way to look at the ovaries, and that ovarians mets will sometimes light up on PET, but I also know of ILC women with ovarian and peritoneum mets who never had anything light up on scans, but whose mets were discovered when they had an oophrectomy. So if you're close to menopause, or if the chemo puts you into menopause, you might want to consider an ooph for peace of mind in the ovary department.
Stage IV Pleomorphic ILC, initially diagnosed at age 38
6/7/2007, ILC, Left, 2cm, Stage IV, metastasized to bone, Grade 2, 0/4 nodes, ER+/PR+, HER2- (FISH)
7/19/2007 Lumpectomy: Left; Lymph node removal: Sentinel
12/27/2007 Whole-breast: Breast, Chest wall
3/1/2008 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
4/24/2015, ILC, Left, 1cm, Stage IV, metastasized to other, Grade 2, 0/10 nodes, ER+/PR+
5/15/2015 Mastectomy; Reconstruction (left): Latissimus dorsi flap
2/1/2018, ILC, Right, 6cm+, Stage IV, metastasized to other, Grade 3, ER+/PR+
2/15/2018 Cytoxan (cyclophosphamide), Taxol (paclitaxel), Taxotere (docetaxel)
6/20/2018, ILC, Both breasts, 6cm+, Stage IV, metastasized to brain/bone, Grade 3, ER+/PR+
7/1/2018 Ibrance (palbociclib)
7/17/2020, ILC, Both breasts, 6cm+, Stage IV, metastasized to brain/bone, Grade 2, ER+/PR+, HER2- (FISH)
7/17/2020 Xeloda (capecitabine)
Faslodex (fulvestrant), Zoladex (goserelin)