Topic: mets to lung

Forum: Stage IV/Metastatic Breast Cancer ONLY — Please respect that this forum is for members with stage IV/metastatic breast cancer ONLY. There is a separate forum for caregivers and friends: Caring for Someone with Stage IV or Mets.

Posted on: Jan 6, 2012 12:53PM - edited Oct 12, 2013 11:32AM by bhd1

Posted on: Jan 6, 2012 12:53PM - edited Oct 12, 2013 11:32AM by bhd1

bhd1 wrote:

hello. i got scan rusults yesterday. looks like abraxane is not working, since cancer is spreading. i am going on navelbine now. any words of encouragement? thanks. i am new to the boards, happy to find you all

barb

barb Dx 9/22/2011, IDC, 3cm, Stage IV, Grade 3, ER-/PR-, HER2+
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Apr 5, 2022 12:52AM carmstr835 wrote:

I did get the path back on the left lung biopsies. HR+ PR weakly positive 3% and Her2 equivical, then FISH came back negative. They did not do the path on the nodules in my right lung. I had 2 primary breast cancers, the left lung path is following the characteristics of the left breast cancer, but it was the right breast that was HER2 + and the right lung positive lymph nodes were nearer where the right breast cancer was. I have sent a message to a 2nd opinion oncologist to check the path on these lung nodules. I am scheduled to start Navelbine on thursday. I don't know what to expect. If anyone can chime in with some info, it would be appreciated.

Hormonal Therapy 3/22/2017 Arimidex (anastrozole) Surgery 3/27/2017 Lymph node removal; Lymph node removal (Right): Sentinel, Underarm/Axillary; Mastectomy; Mastectomy (Left); Mastectomy (Right); Reconstruction (Left): DIEP flap; Reconstruction (Right): DIEP flap Chemotherapy 5/17/2017 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Targeted Therapy 6/27/2017 Perjeta (pertuzumab) Targeted Therapy 6/27/2017 Herceptin (trastuzumab) Chemotherapy 6/27/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 9/11/2017 Breast, Lymph nodes, Chest wall Surgery 7/10/2018 Reconstruction (Left): DIEP flap; Reconstruction (Right): DIEP flap Surgery 10/16/2018 Reconstruction (Left): Fat grafting; Reconstruction (Right): Fat grafting Surgery 9/18/2019 Reconstruction (Left): Fat grafting; Reconstruction (Right): Fat grafting Surgery 3/8/2022 Dx IDC, Both breasts, 1cm, Stage IIB, Grade 2, 2/17 nodes, ER+/PR-, HER2+, ISH, IHC Dx IDC, Other, 1cm, Stage IV, Grade 2, 2/17 nodes Targeted Therapy Nerlynx Surgery
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May 5, 2022 06:07PM bookgal wrote:

Hi all. My question is about pleural effusions and when to have a thoracentesis. I have had a medium/large pleural effusion since my MBC diagnosis 3 years ago. It has been stable and I have not had any SOB symptoms in normal day to day activities.

Recently my new onc suggested that I meet with an Interventional Radiologist to see if they would recommend doing a thoracentesis after all this time. My prior doctors seemed to give me the impression that the pleural fluid is left alone until symptomatic or major progression of volume. I have only been drained once at diagnosis years ago. I am interested to hear about anyone's experiences with pleural effusions/thoracentesis. Any good questions I should ask the radiologist PA? Things to look out for? Do your docs have you wait until you have symptoms to get it drained?

I would like to know what happens when/if the lung decides not to reinflate. How can they help you then? I don't currently have any active lung nodes. There is one that showed up on PET after my initial thoracentesis but that has been stable without activity ever since. Any tips or suggestions are welcome. I am learning so much from you all! Thank you!

Dx 6/2013, IDC/DCIS/LCIS/ILC, Right, 6cm+, Stage IIIA, Grade 2, 10/13 nodes, ER+/PR+, HER2- Chemotherapy 8/26/2013 Cytoxan (cyclophosphamide), Ellence (epirubicin), Taxol (paclitaxel) Hormonal Therapy 6/1/2014 Femara (letrozole) Targeted Therapy 11/1/2019 Kisqali Hormonal Therapy 3/4/2020 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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May 5, 2022 06:45PM denny10 wrote:

Hi bookgirl, it does seem strange to suggest thoracentesis when you have no new symptoms. I have had the procedure twice, both times when I became increasingly breathless due progression. I did not have a choice, so I cannot help you with what questions to ask when you see the radiologist. I can say it was a relief when the fluid was removed. I hope someone who has been in a similar situation to you chimes in and helps.

12/2021 Stage IV TN Dx 2007, Left, Stage IIB, HER2- Dx 12/2013, Right, Stage IV, metastasized to liver/lungs/other, ER+ Hormonal Therapy Faslodex (fulvestrant), Femara (letrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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May 5, 2022 09:02PM sadiesservant wrote:

Hi Bookgirl,

I’m in the same boat as Denny in that I can’t really provide advice. I had a large right pleural effusion when I was first diagnosed as metastatic which kept getting worse, causing extreme shortness of breath and coughing. At its worst I could barely walk 10 feet without gasping. I had a thoracentesis but the fluid quickly returned. We then inserted a PleurX Catheter so that it could be drained twice a week. It took several months until it finally dried up and now I have had a small amount of loculated fluid in pockets ever since. It never changes much and doesn’t cause issues so we leave it alone.

It does seem odd to do something after all this time but it also seems odd to me that they left it if it is moderately large. I think it can permanently damage the lung if left - only about 2/3 of my right lung is functioning at this point. Perhaps that’s the thinking? I would reach out to your MO to see if they can shed more light on why they are suggesting this.

Dx 4/2001, IDC, Right, 1cm, Stage IIA, Grade 3, 1/10 nodes, ER+ Surgery 5/11/2001 Lumpectomy; Lumpectomy (Right); Lymph node removal; Lymph node removal (Right): Sentinel, Underarm/Axillary Chemotherapy 6/7/2001 CEF Radiation Therapy 12/17/2001 Whole breast: Breast Hormonal Therapy 12/20/2001 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/2/2007 Femara (letrozole) Hormonal Therapy 10/22/2007 Arimidex (anastrozole) Dx 1/3/2017, IDC, Right, Stage IV, metastasized to bone/lungs, ER+/PR+, HER2- Chemotherapy 1/27/2017 Taxol (paclitaxel) Hormonal Therapy 3/29/2017 Arimidex (anastrozole) Targeted Therapy 4/20/2017 Ibrance (palbociclib) Dx 10/12/2017, IDC, Right, Stage IV, metastasized to other Chemotherapy 10/21/2017 Xeloda (capecitabine) Radiation Therapy 11/15/2017 External Local Metastases 11/15/2017 Radiation therapy: Bone Hormonal Therapy 1/19/2018 Faslodex (fulvestrant) Radiation Therapy 8/2/2018 External Local Metastases 8/2/2018 Radiation therapy: Bone Radiation Therapy 11/5/2018 External Local Metastases 11/5/2018 Radiation therapy: Bone Targeted Therapy 10/10/2019 Verzenio Radiation Therapy 11/3/2020 External Local Metastases 11/3/2020 Radiation therapy: Bone Dx 1/22/2021, IDC, Right, 1cm, Stage IV, metastasized to liver, Grade 2, ER+/PR+, HER2- Chemotherapy 2/4/2021 Xeloda (capecitabine) Chemotherapy 10/8/2021 Other Chemotherapy 1/7/2022 Other
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May 5, 2022 09:57PM - edited May 5, 2022 10:00PM by parakeetsrule

If it's been there for three years and it's been compressing your lung all this time, I would guess that there's already a pretty good chance your lung won't reexpand. I only had an effusion for maybe six months and after the last thoracentesis my lung didn't reexpand.

If it's not bothering you I'd probably leave it alone.

Pulmonologists seem to have varying opinions on it. The first one I saw wanted to put in a drainage catheter right away during the first thoracentesis. Another one on the same team that I met months later told me he preferred to leave effusions alone if they aren't bothering the patient. I had five thoracentesises(??), one per month, until after the last one the fluid stopped filling up so fast. Two months later my lung still had not recovered though. Luckily it's only lost maybe a quarter to a third so I'm fine!

Stage 2 at 37, Stage 4 at 41. Cancer is dumb. Cookies are good. Dx 3/21/2017, IDC, Left, Grade 2, ER+/PR-, HER2- Chemotherapy 5/14/2017 AC + T (Taxol) Hormonal Therapy 12/8/2021 Faslodex (fulvestrant) Targeted Therapy 12/13/2021 Piqray (alpelisib) Dx IDC, Other, Stage IV, ER+, HER2- Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal (Left); Mastectomy (Left) Radiation Therapy Whole breast: Lymph nodes, Chest wall
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May 6, 2022 06:33PM susaninsf wrote:

I agree with parakeetsrule. The main reason to get a thoracentesis even if you don't have symptoms is so that your lung will reinflate. After three years, reinflation is unlikely. Since you aren't experiencing any symptoms, that's seems ok. How much fluid was taken out the last time you had a Thoracentesis?

Wonderful that you no longer have any active lung nodes. Your pleural effusion should not get worse if your disease is minimal and stable.

Hugs, Susan

Mets to brain, lung, liver, eye, femur bone. Dx 2000, DCIS, <1cm, Stage 0, Grade 3, 0/2 nodes, ER+/PR+, HER2- Surgery 8/31/2000 Lumpectomy; Lumpectomy (Left); Lumpectomy (Right); Lymph node removal; Lymph node removal (Right): Sentinel; Reconstruction (Right) Dx 2008, DCIS, <1cm, Stage 0, Grade 3, 0/2 nodes, ER+/PR+, HER2- Surgery 3/2/2008 Mastectomy; Mastectomy (Right) Dx 3/29/2014, DCIS, Left, 4cm, Stage IV, metastasized to brain/bone/lungs/other, mets, ER+/PR-, HER2- Hormonal Therapy 3/31/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 4/28/2014 External Local Metastases 4/28/2014 Brain Chemotherapy 10/30/2014 Xeloda (capecitabine) Radiation Therapy 1/8/2015 External Local Metastases 1/8/2015 Radiation therapy: Bone Radiation Therapy 6/6/2016 External Hormonal Therapy 11/16/2016 Faslodex (fulvestrant) Targeted Therapy 12/21/2016 Ibrance (palbociclib) Radiation Therapy 11/27/2017 External Local Metastases 11/27/2017 Brain Hormonal Therapy 8/21/2018 Femara (letrozole) Targeted Therapy 8/21/2018 Piqray (alpelisib) Chemotherapy 4/23/2019 Taxol (paclitaxel) Chemotherapy 6/19/2019 Abraxane (albumin-bound or nab-paclitaxel) Radiation Therapy 10/23/2019 External Local Metastases 10/23/2019 Brain Immunotherapy 10/25/2019 Targeted Therapy 2/18/2020 Trodelvy (sacituzumab govitecan-hziy) Dx 3/8/2021, Stage IV, metastasized to liver Hormonal Therapy 3/12/2021 Aromasin (exemestane) Targeted Therapy 3/16/2021 Verzenio Chemotherapy 9/8/2021 Other Chemotherapy 11/2/2021 Other Targeted Therapy 1/6/2022 Targeted Therapy 6/24/2022 Enhertu (fam-trastuzumab deruxtecan-nxki)
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May 6, 2022 09:43PM - edited May 6, 2022 09:44PM by parakeetsrule

I actually landed in the hospital after the last thoracentesis because when my lung didn't reexpand, my body decided to fill the new gap with air! They always do an xray shortly after the procedure so that's when they noticed it. They weren't sure at the time if the air pocket was growing or why it was there so they admitted me out of an abundance of caution. They were afraid it would keep growing and collapse my lung! But it turned out fine. The gap just refilled with fluid in the space where my lung would normally be and I guess the air got reabsorbed ?


I forgot earlier but there was also a small pocket towards the top of the lung that did reexpand. But it was only maybe 5% of the lung, judging from what my uneducated eye could see on the xray!

Stage 2 at 37, Stage 4 at 41. Cancer is dumb. Cookies are good. Dx 3/21/2017, IDC, Left, Grade 2, ER+/PR-, HER2- Chemotherapy 5/14/2017 AC + T (Taxol) Hormonal Therapy 12/8/2021 Faslodex (fulvestrant) Targeted Therapy 12/13/2021 Piqray (alpelisib) Dx IDC, Other, Stage IV, ER+, HER2- Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal (Left); Mastectomy (Left) Radiation Therapy Whole breast: Lymph nodes, Chest wall
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May 8, 2022 08:52PM susaninsf wrote:

parakeetsrule,

So sorry to read about your experience. Yikes! That's scary! I've never had an x-ray after the procedure. Glad they took good care of you.

Hugs, Susan

Mets to brain, lung, liver, eye, femur bone. Dx 2000, DCIS, <1cm, Stage 0, Grade 3, 0/2 nodes, ER+/PR+, HER2- Surgery 8/31/2000 Lumpectomy; Lumpectomy (Left); Lumpectomy (Right); Lymph node removal; Lymph node removal (Right): Sentinel; Reconstruction (Right) Dx 2008, DCIS, <1cm, Stage 0, Grade 3, 0/2 nodes, ER+/PR+, HER2- Surgery 3/2/2008 Mastectomy; Mastectomy (Right) Dx 3/29/2014, DCIS, Left, 4cm, Stage IV, metastasized to brain/bone/lungs/other, mets, ER+/PR-, HER2- Hormonal Therapy 3/31/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 4/28/2014 External Local Metastases 4/28/2014 Brain Chemotherapy 10/30/2014 Xeloda (capecitabine) Radiation Therapy 1/8/2015 External Local Metastases 1/8/2015 Radiation therapy: Bone Radiation Therapy 6/6/2016 External Hormonal Therapy 11/16/2016 Faslodex (fulvestrant) Targeted Therapy 12/21/2016 Ibrance (palbociclib) Radiation Therapy 11/27/2017 External Local Metastases 11/27/2017 Brain Hormonal Therapy 8/21/2018 Femara (letrozole) Targeted Therapy 8/21/2018 Piqray (alpelisib) Chemotherapy 4/23/2019 Taxol (paclitaxel) Chemotherapy 6/19/2019 Abraxane (albumin-bound or nab-paclitaxel) Radiation Therapy 10/23/2019 External Local Metastases 10/23/2019 Brain Immunotherapy 10/25/2019 Targeted Therapy 2/18/2020 Trodelvy (sacituzumab govitecan-hziy) Dx 3/8/2021, Stage IV, metastasized to liver Hormonal Therapy 3/12/2021 Aromasin (exemestane) Targeted Therapy 3/16/2021 Verzenio Chemotherapy 9/8/2021 Other Chemotherapy 11/2/2021 Other Targeted Therapy 1/6/2022 Targeted Therapy 6/24/2022 Enhertu (fam-trastuzumab deruxtecan-nxki)
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May 20, 2022 01:40AM carmstr835 wrote:

I just completed 2 cycles of navelbine and I think it is not working. My CA-15 cancer markers have doubled since before the chemo to 43. Anyone know the next line of chemo? Or will they complete the 3rd cycle and do a ct scan. Do cancer markers drive the chemo decisions? I didn’t get my chemo today. Oncologist wants to see me in the morning first. So chemo is delayed. I hope they have another plan if this chemo isn’t working. I am pretty concerned. I am ER + Pr - HER2 +2 equivocal IHC. neg with FISH. I am refusing anti hormones drugs and I am not sure there is anything else. I will know tomorrow. I know he mentioned enhertu as the next line. Any suggestions of ideas for treatment is very much appreciated.

Hormonal Therapy 3/22/2017 Arimidex (anastrozole) Surgery 3/27/2017 Lymph node removal; Lymph node removal (Right): Sentinel, Underarm/Axillary; Mastectomy; Mastectomy (Left); Mastectomy (Right); Reconstruction (Left): DIEP flap; Reconstruction (Right): DIEP flap Chemotherapy 5/17/2017 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Targeted Therapy 6/27/2017 Perjeta (pertuzumab) Targeted Therapy 6/27/2017 Herceptin (trastuzumab) Chemotherapy 6/27/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 9/11/2017 Breast, Lymph nodes, Chest wall Surgery 7/10/2018 Reconstruction (Left): DIEP flap; Reconstruction (Right): DIEP flap Surgery 10/16/2018 Reconstruction (Left): Fat grafting; Reconstruction (Right): Fat grafting Surgery 9/18/2019 Reconstruction (Left): Fat grafting; Reconstruction (Right): Fat grafting Surgery 3/8/2022 Dx IDC, Both breasts, 1cm, Stage IIB, Grade 2, 2/17 nodes, ER+/PR-, HER2+, ISH, IHC Dx IDC, Other, 1cm, Stage IV, Grade 2, 2/17 nodes Targeted Therapy Nerlynx Surgery
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May 21, 2022 12:53AM nopink2019 wrote:

Gven the state of "upgrade" I'm not sure if you can tell my MBC progress so I will recap. 2019, breathing problems. Thoracentisis showed MBC. Scans showed lungs & liver. Last scan in Feb showed only liver nodes remain. Had 5 thoro, about 3 weeks apart. 2 liters was most fluid taken @once. Left lung still shows hardening on CT, about 1/4 to 1/3 lights up. Breathing getting worse, not so much when vertical, but really nad in horizontal position. I don't think there is anything to improve the damage, but has anyone found breathing exercises that help? I have to sleep with Menthol cough drops in order to breathe. I've also started taking puff of oxygen when lying down. Even bending over the garden makes me cough and sometimes dizzy. Suggestions, experiences all welcome.

Chemotherapy 8/23/2019 Taxotere (docetaxel) Chemotherapy 9/20/2019 Xeloda (capecitabine) Hormonal Therapy 11/13/2019 Faslodex (fulvestrant) Targeted Therapy 11/13/2019 Kisqali Hormonal Therapy 5/10/2021 Aromasin (exemestane) Targeted Therapy 5/10/2021 Afinitor (everolimus) Chemotherapy 11/28/2021 Other Chemotherapy 6/1/2022 Other Surgery Lumpectomy (Left); Lymph node removal (Left): Sentinel Chemotherapy AC + T (Taxotere) Radiation Therapy Whole breast: Left breast

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