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Suggest Treatment For Infiltrating Ductal Carcinoma

Posted on Wed, 5 Apr 2017

Question: In the year 2014, my mother has been diagnosed with “Advanced Infiltrating Duct Carcinoma Grade-II” in Left Breast. After Mastectomy,several Chemotherapy,Radiation Therapy has been done. She has been under Hormonal Therapy (Anastrazole) since then. But on Dec’2016 after routine test and biopsy doctor said that cancer has been metastasized i.e. spread onto the liver aggressively i.e. Metastasis Adenocarcinoma. After further investigations it has been observed that cancer spreaded to right breast,lungs and other parts of body simultaneously and leads to Hepatic,Skeletal and Lung Metastasis. After consulting with several doctors, Oral chemotherapy(Capacitabine,Letroz) has been started as a part of palliative care.Can you suggest any other line of treatment? Whether Oral chemotherapy is enough or IV chemotherapy also needed?

Answered by Dr. Deepak Sundriyal (4 hours later)

Brief Answer:
Hello dear. Some test are required

Detailed Answer:
Hello dear. I have gone through the details and i understand your concern. So its a metastatic carcinoma now and tumor load is high. She requires determination of er pr and her2 expression of tumor by a repeat biopsy as they may change and may modify drug therapy.
Accordingly, chemo can be planned. Oral capecitabine is a weak drug.
Also there is no point in combining letroz and chemo together.
If her condition iz good, then good drugs like nab paclitax or docetaxel can be tried.
Thanks and regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Deepak Sundriyal (5 hours later)

ER,PR,HER2 test has been done previously of breast tumour. Do it need to be done again from liver biopsy?

Answered by Dr. Deepak Sundriyal (2 hours later)

Brief Answer:
Hello. Yes it should be repeated

Detailed Answer:
Hello. Er per her2 rrceptor expression changes in metastatic disease and hence requires retesting. It will change treatment.
Thanks and regards

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Above answer was peer-reviewed by : Dr. Kampana