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Has metastatic breast, got a hormonal therapy tamoxifen faslodex. Which chemotherapy is the best?

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Practicing since : 2002
Answered : 2397 Questions

My Mom have metastatic breast CA

HER-2 Negative PR++ ER+++

she got hormonal therapy tamoxifen faslodex

and now the Dr said she need to take chemotherapy

my question to you what is the best chemotherapy for her case and if there biological therapy that work with the chemo therapy in her case
i heard alot about new medicine for this case of CA

please advice
Posted Wed, 2 May 2012 in Cancer
Answered by Dr. Robert Galamaga 2 hours later
Hello and thank you for submitting your question.

Your question is a good one and I will work on providing you with some good information and recommendations regarding what is going on.

I would like you to clarify the date of the initial diagnosis of the breast cancer. It is also important to specify how large the primary tumor was and also if there were any positive lymph nodes. This really has a major impact on the recommendations for subsequent treatment.

She will certainly benefit from hormonal therapy and we usually get hormonal therapy for at least five years. If she does qualify for chemotherapy there are several standard chemotherapy regimens which have been tested over the years to work very well to help limit the likelihood that her disease will recur.

Specifically I would like you to let me know the size of the primary tumor as well as what the pathologist described in the pathology report. This is very important information in order to help us provide good recommendations.

I can certainly respect the fact that you are dealing with a stressful situation here and I will certainly do my best to try and give you helpful information. I look forward to hearing back from you regarding the details of her diagnosis.


Dr. Robert
Above answer was peer-reviewed by
Follow-up: Has metastatic breast, got a hormonal therapy tamoxifen faslodex. Which chemotherapy is the best? 1 hour later
Hello Dr

i did got few more info from her Dr

S/P mastectomy 1969
S/P chemotherapy AC 1996 Neoadjuvant
Local reccurent RT Axilla biopsy ER positive
multiple bones 2005 mets liver mets 2010
impending SCC 2011
S/P Radiotherapy D11-13
S/P radiotherapy C1-C6
S/p subtotal resection of skull lesion RT occipital HER2 negative PR++/ER+++
S/P hormon thereby tamoxifen al faslodex 2005 - 2011
S/P chemothrapy xeloda 7/2011 11/2011
Answered by Dr. Robert Galamaga 22 hours later
Hello and thank you for the follow up question.

The information you provided is helpful.

At this point there is no biological therapy that has proven benefit in patients with her history.

We guarding chemotherapy options one might consider treating her again with AC (cyclophosphamide, doxorubicin) but there has to be a very careful consideration of her baseline cardiac function as this chemotherapy can affect her heart.

Another medication which is reasonable to consider is Ixabepilone (Ixempra). This medication has been shown to have activity in advanced cases of breast cancer. Eribulin is another agent which I have seen have very good activity in patients we do have advanced metastatic breast cancer.

At this point certainly the goal of therapy for your mother is to control the disease. This is unfortunately something that the doctors cannot sure. Modern medicine does afford us the ability at the same time to provide patients with good quality of life in the setting of a very debilitating illness.

I'm sure this is very stressful for her and also for you. another possibility would be to discuss with the oncologist to see if there might be any clinical trial that your mother might be able to participate in. Again in a clinical trial does not guarantee that the patient will receive the study medication. This is still worthwhile to consider.

I thank you again for submitting your question. I hope you have found my response to be helpful and informative with additional considerations. If you have any additional concerns I would be happy to address them.


Dr. Robert

Above answer was peer-reviewed by
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