Do you need chemo to battle metaplastic breast Cancer?

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Information about Do you need chemo to battle metaplastic breast Cancer?
Health & Medicine

Published on June 26, 2014

Author: benaroberts1



Do you need chemotherapy to fight metaplastic breast cancer? Case study of a 70 year old woman who only had radiation therapy to battle Spindle Cell metaplastic breast cancer.

Do you need Chemo to battle Metaplastic Breast Cancer?

Can you treat metaplastic breast cancer with only radiation? • It is often stated that chemo does not work with metaplastic breast cancer (MBC). However, it is given as the strongest possible deterrent to reoccurrence after surgery. This case study aims to detail the scenario of a 70 year old woman who declined conventional treatment for metaplastic breast cancer. • The 70 year old female was offered a radical mastectomy, chemotherapy (FECx6) and radiation. Instead she only had radiation.

Patient History i. T2, N0 metaplastic breast carcinoma was found on the right breast. i. Another 2mm lobular carcinoma was also found. i. The mass was Triple Negative and slightly KI67 positive. The patient discovered a mass on her breast in May 2011. The original mass was 1.9cm but it grew to 3cm by July 2012 when it was biopsied. The mass was originally considered to be a cyst. It was removed in September 2011. Following removal came radiation therapy for one month. The patient refused her doctor’s advice and did not have chemotherapy.

July 2011 Nov 2011 March 2012 2012May 2011 2013 Found a lump Solid lump found by patient in May 2011. Visited family doctor. Removal of tumour TNBC, KI67 +, MBC spindle cell plus 2mm lobular carcinoma Cancer free The patient was cancer free for the whole of 2012 Biopsy Due to ultrasound and mammogram mass considered threatening with sarcomatoid features Radiation 40GY of radiation therapy completed. New possible Cancer found in the leg. A mass growing outside of the leg resembling a boob with a nipple CANCER TIMELINE – Metaplastic Breast Cancer Spindle Cell

Lymph Node (0/5) HER2 Negative Radiation Treatment Plan See Above 40 GY BRCA Negative 2 completely different types of cancer MBC and Lobular 2012201220112011 Timeline in 2011 Course ID Plan ID RX Dose Fraction 1R + Breast RT Boost 10 5/5 1R+ Breast RT Boost 40 15/15

Image of Breast Scar

New Cancer found in 2013 • The patient was cancer free for one year. • Found a suspicious lesion on her right calf in January 2013 which was dismissed by her doctor. The lump continued to grown and was a mass outside of her skin. In September she was initially diagnosed as a metaplastic lesion. • Examination – 2x1.5cm erythematous nodule over the medial aspect of the right calf. • Diagnosis – after operation and removal in December 2013 - cystic lesion right leg with squamous cell carcinoma in situ with a cyst wall. • According to her medical team there was no evidence of any relation to the old cancer.

Sept 2013 Dec 2013 Dec 2013 2013Jan 2013 2014 Found new lesion on leg of 72 year old female patient with history of MBC Removal of tumour Due to previous cancer quick removal of new lesion No treatment Patient opted out of all treatment for new cancer Patient went for an ultrasound and was treated quickly Diagnosis: 2x1.5 cystic lesion with squamous cell carcinoma in Situ with a cyst wall. Cancer Free The patient is currently cancer free CANCER TIMELINE – Squamous Cell Carcinoma in Situ Http:// cer

Image of leg scar

Medics state that there are no similarities between both cancers but there are similarities that cannot be dismissed All cancer was on the right side of the body. Both cancers were originally perceived to be cysts. One cancer was treated slowly and grew to include a whole new cancer (lobular) on removal – despite showing large cells at biopsy. Her original pathology shows Spindle Cell and her new cancer is Squamous – both are sub-types of MBC. Furthermore, crystallised forms of tumour were discovered but were not tested. The first cancer had a chance to grow and was more aggressive. The second cancer had a change to grow from 0- 2cm but wasn’t biopsied. The cyst that was profiled showed Suamous elements hance her diagnosis. This means that new growth patterns could not be assessed.

Conclusion • Even though doctors disagree. We believe that there are some similarities between the patients cancer. Her leg biopsy was botched despite showing crystallised formations that resemble a metaplastic tumour. • But, this is overshadowed, by the fact, that the lady despite an aggressive diagnosis has survived MBC with only one reoccurrence. This is without doing chemotherapy. This must show a positive outcome for patients with a similar T2, NO diagnosis. • In 2014 the lady is alive and well with no existing cancer. Current medication includes Statin and Pantropozole.

Quick synopsis of 6 known patients that chose radiation only Two women Squamous Grade 1 MBC one 1.5 years cancer free and one 4 years cancer free Carcinocarcinoma patient with radiation only. Reoccurrence and mets. Deceased. Our 70 year old case study with Squamous and 1 similarly aged woman with Grade 2 MBC – 1 year cancer free 52 year old woman – undisclosed details With only six women we know of that have chosen only radiation: mere assumptions can be made. Low grade MBC (under 2A) and no lymph nodes can be treated with radiation after surgery. Four women have had success. However more aggressive tumours (above 2b) should be treated more aggressively. However, a reoccurrence did occur in this case and maybe chemo would be the preferred choice for a cancer free future.

BENA ROBERTS WWW.BENAROBERTS.COM WWW.METAPLASTICBREASTCANCER.NET Please contact me: We are actively looking for a PhD student or similar to analyse our data

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