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History: My Aunt Was Diagnosed With T2N0M0 Breast Carcinoma One

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Posted on Sat, 6 Oct 2018
Question: History: My aunt was diagnosed with T2N0M0 breast carcinoma one and half year back and operated in XXXXXXX 2017. Tumor was 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.

Recently she had urine infection kind of symptoms but since the culture report came negative, her urologist given her Lupin Mira 50 mg muscle relaxation tablet along with a vaginal cream Estriol(image attached).

Since she is a ER/PR positive breast cancer survivor, I am not sure if she can apply Estriol cream which is estrogen based. We realised this after she used it for 1 week(7 days).

Kindly advise on the implication of using it and should we do anything about it now.

doctor
Answered by Dr. Indranil Ghosh (33 hours later)
Brief Answer:
Avoid estrogen creams

Detailed Answer:
Hi
Thanks for following up.

The exact implications of topical estrogen on breast cancer recurrence is not known. However, some of it can be absorbed. Especially that her tumor was ER positive, and we are giving Femara to reduce whatever estrogen she has in our body, it will be prudent to avoid topical estrogen in her.

it will be very difficult to ascertain the effect of what has been already applied but one week is probably too short a duration to have any impact.

Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Indranil Ghosh (7 hours later)
Thanks for the response.

It looks like she has vaginal dryness and because of which she has lot of irritation in that area, bladder along with some back pain. It looks more like the side effects of the Femara she is taking.

Can she try something else instead of hormone based vaginal creams? Also, she started feeling more irritated after applying the Estriol cream and stopped applying it after a week. Luckily I saw the composition of the medicine and told her to not to apply further.

Also, is it better to take oncologist opinion before starting medication for any other problems in future? Inspite of clearly telling him about her history, unfortunately urologist suggested the estrogen cream which I believe is not right.

Her urologist told us to come back after 3 weeks if the symptoms don't improve. Please advise on what best can be discussed with urologist from the oncology perspective and your suggestion to this problem.
doctor
Answered by Dr. Indranil Ghosh (2 hours later)
Brief Answer:
Non estrogen lubricants

Detailed Answer:
She can use nonestrogen lubricants. And yes, it's better to consult oncologist before starting new medicines.

You can consult her oncologist regarding her present problem. If he feels he can refer her to another gynecologist or urologist of his choice and maybe brief him or her regarding her condition.

Regards
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
Dr.
Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1712 Questions

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History: My Aunt Was Diagnosed With T2N0M0 Breast Carcinoma One

Brief Answer: Avoid estrogen creams Detailed Answer: Hi Thanks for following up. The exact implications of topical estrogen on breast cancer recurrence is not known. However, some of it can be absorbed. Especially that her tumor was ER positive, and we are giving Femara to reduce whatever estrogen she has in our body, it will be prudent to avoid topical estrogen in her. it will be very difficult to ascertain the effect of what has been already applied but one week is probably too short a duration to have any impact. Hope this helps. Regards