Question: Hello Doctor

This is again a follow up question for my aunt with T2N0M0 breast carcinoma. 3cm, ER+, PR+, HER2--. Quadrantectomy done with axillary dissection. TC*4 chemo given with 21 days radiation. Chemo completed on 27th March, 2017. Radiation completed on 26th May, 2017. Currently on Femara.

Last week(Wednesday) Dexa scan is done and because of Osteopenia, ZYCLASTIN 5mg was administered.

Yesterday we gave her Pneumovax vaccination.

She was complaining of little neck pain yesterday and today she is saying it has increased. Mainly the pain is at back of the neck, head area above the back neck and little on the shoulder. She is complaining of pain in the back head and neck area when she try to swallow some food as well.

Anything to concern? and any suggestion for this pain management.
After reading lots on cancer, we are very much worried on mets and just don't want to take any chance.

Consulted the orthopedic doctor and he took the x-ray of neck from the back and side and told it looks normal. Given muscle relaxation, nerve relaxation and pain killer tablets.

Also, told to get an opinion from an ENT specialist as she complains about neck pain while swallowing food. Also, in the x-ray the throat area was little dark. She had little cough last week and it is now ok.

Questions:

1. Do you think should I consult an ENT specialist for this?
2. If yes, can I wait for 2 to 3 days and see if the pain subsides with the medications already given by orthopedic?.
3. I believe that the neck pain has radiated to her throat and this is the reason she is having neck pain while swallowing food and also while pressing the throat. Can this be a possibility?
4. As she is already taking many medication, I just want to avoid any further tests and medications by ENT doctor and do if it is not absolutely needed. Your views please.
5. Is she at risk of developing throat and thyroid cancer because of her existing breast cancer history? We are thinking way too much because anything we see somehow gets correlated to cancer in back of our mind.

Thanks for your response.

She was having mild cough when she took Pneumovax vaccination this Tuesday.
Can this be the side effect of the Pneumovax vaccination?

I feel that the pain has actually aggravated after taking the Pneumovax vaccination but not sure though.

Also, I was not sure whether to take X-Ray when the Orthopedic suggested it yesterday. I know that unnecessary exposure to X-Ray will increase the cancer risk. Should I be very careful with X-Ray in future and do it when it is absolutely needed.