Friend diagnosed with Met BC ... not offered biopsy

arpie

A friend who had BC in her right breast 20 years ago has just been diagnosed with Met BC (from a biopsy of a left rib following a period of unexplained rib pain.)  It is not in her lungs or liver and she will be having a brain scan to make sure it is not there as she's been having the odd headache recently ... fingers crossed it is not there.

She apparently won't be doing chemo - but is on a Hormone Blocking Drug (possibly Anastrozole) and there is talk of radiation at some stage.

She is not up with computers, so thought I'd put the odd questions past you for your opinion .....

The Mammogram/UltraSound has shown a lesion in the right breast again - but at this point the boffins have not suggested a biopsy (or removal) which I thought was a bit strange?  We both thought at least a biopsy would be offered .... are we over-reacting?  Has this happened to any of you?  Is it normal?  Would you request a biopsy even if the Specialist hasn't offered it?

Some of my own history - I was diagnosed with BC in early Jan, had surgery mid Jan & radiation for 4 weeks leading up to Easter.  I've just started Letrozole 2 days ago.

TonyaM

I’m guessing that because a bone biopsy was taken,they don’t need a breast biopsy but your friend should ask her specialist. However,if it was me,I’d want a breast biopsy incase the pathology was different to the bone pathology.Or it may not even be a breast cancer but I’d like to know unless my doctor gave me good reasons otherwise.

arpie

Many Thanks @TonyaM  - that is what we were both thinking too.  Just the thought that it COULD be another tumour that continues growing is not good for the morale, either, even tho the other treatment has already started.  Quite the opposite, in fact - it would undermine her confidence in the process, I think.  

I am guessing her GP could also OK the request for a biopsy?  I reckon she'll check with her GP first to ask for one & if SHE says no -  a reason for NOT to have a Biopsy! I personally would still want one!  If it WERE positive to cancer - surely they'd want it removed as well, rather than letting it stay there .... I know the condition, long term, is terminal - but no need to have an EXTRA Damocles Sword hanging over your head, eh?

TonyaM

It may well be that the doctors want to see if the medication shrinks the lesion in the breast but then surely they’d need to confirm it’s definitely bc.So I’m in total agreement with you arpie.Hope she can get some answers from her GP.

Kattykit

I have it in my bones and a few other places and am on Ribociclib plus letrozole and denosumab , I had a biopsy when they put the pin in my leg, which means they don't need to test the others and no mention of surgery to remove any of the other tumours, the combination is shrinking the tumours so far.
 

primek

Well I'd be asking again as a friend of mine recently diagnosed with Es+ mets  (8 years aftet first bc) with her workup was discovered to have a new primary of her other breast. This was treated as any other. ..and the biopsy showed her2+. So she is undergoing standard treatment for that but will continue with her mets plan also. 

Brenda5

Thats what I was thinking @primek , sometimes it can be a separate new primary and one less thing to carry long term. 

Tilly45

Hi @arpie when I was diagnosed my oncologist put me straight on hormone med. to block oestrogen. No chemo, radio. or operations. He did do a biopsy but said it was just a formality. He said the treatment was hopefully going to be effective and that the primary breast lump was not the priority, rather the areas where the cancer had spread. I have CT scans every 6 weeks and tumour markers checked every 2 weeks. He says as long as they are dropping or stay the same he is happy. I have now been put on ribociclib. My tumour markers have decreased so my body is responding well to the medication. 

poodlejules

Hi @primek Just out of interest with your friend, was she on hormone blockers for 5 years with her first bout of BC? Ta, J

arpie

Many thanks guys.  I spoke with my buddy yesterday & after just one week on the tablets (ariadne or ariane or  a similar female sounding name - she wasn't 100% sure of it ...) she is feeling like shit.   It is making her feel nauseous, unstable on her feet & not at all comfortable with it - so was going to contact the Onc to see it that was normal after just a week ..... or if she is having an abnormal reaction to it & should be on something else.

They are going to Norfolk Island for a holiday at the end of the month (with the blessing of the Onc) ..... so I just hope she is well enough to do it!!     

@Tilly45  Thank you so much for that information - I had thought that it could be the case - to treat the bone side of things rather than any actual lesion since found ..... great to hear that your Tumour Markers have decreased.  Could I ask which Tablets you are on initially?  How come you changed to Ribociclib?   Are you seeing Begbie or Shakespeare?  Begbie was in charge of my husband's chemo in 2010 when he had most of his stomach removed from cancer, then had lots of chemo as well.

primek

@poodlejules Yes she was on hormone blockers for 5 years. Her mets were found when she had appendicitis during the workup. She had no symptoms  at that point. She was accepted into the ribociclib trial. 

poodlejules

Thanks @primek. Hope she's doing ok x

arpie

Good news, my friend's rad onc made contact and she is to have the biopsy this Monday (just in case it is a different cancer than the Met BC.)  She was really stressing out over it.

I can 'sort of' understand why they didn't offer it in the first place - I guess they reckon she'll be dying eventually of the bone mets - so why do a biopsy as well (tho they may not word it quite like that ....)

She's had a really horrible week this week - her teenage grandson (still at school) suicided last week & his funeral was yesterday.  500 attended his funeral (most being school friends) .... yet he felt 'alone' and unable to share his fears.  

Her blood pressure has gone thru the roof & is now on valium to help her thru this horrible period of grieving - on top of her recent Met BC diagnosis.

I hope everyone knows that even in the depths of despair - there are family & friends out there to help you thru the troubles ..... it was heartbreaking to see the sorrow yesterday at this lovely young man's funeral.

Sadly, he chose a permanent solution for a temporary problem.    

tigerbeth

So sad @arpie ,thoughts are with your friend xx

arpie

Thanks @tigerbeth  .... up til her grandson's death, she was going really well - she'd accepted that she 'had it' and that it was a slow growing one, and was happy NOT to do chemo - and happy to do the tablets .... but her grandson's passing has just floored her (and her husband.)    

I just hope the results of the biopsy don't compound things further ... xx

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