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Dear Doc My case history is mentioned below: Tumor: Invasive

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Answered by
Practicing since : 2005
Answered : 1263 Questions
Dear Doc

My case history is mentioned below:

Tumor: Invasive Ductal Carcinoma
Grade: II
Diagnosed on October 25th, 2017
Location: 2.O.Clock – Left Breast
Lumpectomy performed on November 24th, 2017
Lymph Nodes: Clear
Margins: Clear
Size of Tumor: 2.5 CM
ER: Positive
PR: Positive
Her2: Negative
Fish: Negative
Oncotype DX Score: 20
1st Chemo Cycle of AC Dose Dens performed on 5th XXXXXXX (46th day after surgery)
2nd Chemo Cycle of AC Dose Dens performed on 19th XXXXXXX (yesterday)


My LFT, CBC and CO2 test were quite OK (except for GGT levels) 1 day before my 1st chemo (Please see attached reports dated 4 Jan)

The same tests were performed on 19th XXXXXXX (just before my 2nd chemo) and my LFT, CBC and CO2 test are pretty much out of order (Please see attached reports dated 19 Jan)

Can you please advise what should I do? I have had no alcohol since my 1st chemo till to-date although I have taken a few paracetamols for headaches in past 2 weeks

I am taking few nutrients including milk thistle which is supposedly good protection for liver? Can you please advice what should I do to improve on my LFTs and CBC's? My next chemo is on 2nd Feb and I am concerned that within next 14 days, my LFTs and CBC will get worse if I don't take any precautions?

My oncologist is out of station and she will be back on 3rd FEB so need a professional / detailed advice with suggestions for any precautions / medications?

Mrs IK

Other important facts:

Age: 46 Years

Menopause: Signs of early stage menopause have been noticed in recent months such as delay in periods

General health conditions: Above average

Side health issues: Experience Migraine / Headache 3-4 times per week

Family History: Nil

Physical Activity: Average 45 minutes rigorous exercise 6 days / week

Personal preference: Would like to avoid chemotherapy

Food intake: Extremely healthy food / diets

Weight: 65 KGs

Height: 5.2 Feet

Bad habits: Consume upto 300 ML of white or red wine atleast 3-4 (11 to 13% alcohol) times per week

Medicines I used before surgery: Calcium, Vitamin D, Primrose & Panadol/Brufen for headache


1. Is it mandatory to undergo chemotherapy treatment followed by radiation and 10 years hormonal therapy

2. Do I have the option to skip chemotherapy treatment and only take radiation followed by 10 years hormonal therapy

3. Only Hormonal therapy is sufficient

Please kindly review my report and above details and give me a solid opinion that you deem most appropriate for me

Sat, 10 Feb 2018 in Cancer
Answered by Dr. Deepak Sundriyal 6 hours later
Brief Answer:
Hello dear. Your results are ok

Detailed Answer:
Hello dear. I have gone through the reports. Your results are ok for undergoing chemotherapy. Mild increase in ast alt level can occur during chemo and thats not a cause of concern. Ggt level can be high due to alcohol. Chemo can be given.
You must take all chemo as oncotype dx is intermediate range.
After that radiation and hormonal therapy.
Limit your alcohol consumption to 60 ml per week.
Thanks and regards
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