Surgery Option or Not?
Hi Everyone, I was diagnosed de novo Stage 4 with breast, lymph node and bone/spine mets in Oct 2018. I've had really good response to treatment with Letrazole/Ribociclib/Denosumab whereby the breast ...
Forum Discussion
Thanks everyone, all your comments and experiences have been helpful and given me things to think about :smiley:
So I've had further ultra sound tests and seen the Surgeon 3 times now with lots of questions - she said I was one of the best prepared people I'd seen! lol :) I've also discussed with my Onco and its also been discussed by the Multi Disciplinary Team.
The general consensus from the MDT was to remove the breast primary with a lumpectomy, leave the lymph nodes. The Surgeon is a little more keen to go after the lymph nodes as well as she wants to minimise potential disease (potentially only Level 1 auxillary clearance or a biopsy/wire type thingy). Even so, she is very conservative and is very concerned about the things that might cause grief particularly the cording and lymphodema. The Onco was saying, you currently have good local control and shrinkage, leave well enough alone for now til things start moving. I'd have to go off the Ribo's 2 weeks before and after surgery (to allow for immunity to bump back up), then just recommence. He suggested no post surgery radiotherapy in the lymphs to mitigate the lympodema possibility. Everyone has said that I've had had remarkable response with the Ribociclib/Letrozole and there seems to be an element of surprise that I've done so well so far - I didn't have anything to gauge that against, so I will take that as a win :)
In the end, I've said to them, let me enjoy my "happy 3 months" until my next restaging scans. I want to see what further progression (more shrinkage hopefully - fingers and toes crossed) happens. I'll then do a complete round of scans and tests again and we can decide. I'm thinking to get the primary out (yes, get the alien out of me! :) ) as I do get some feedback that there is some evidence to suggest taking that out is a good thing to do. The question will be do we or don't we go for the lymph nodes as well....
So I've had further ultra sound tests and seen the Surgeon 3 times now with lots of questions - she said I was one of the best prepared people I'd seen! lol :) I've also discussed with my Onco and its also been discussed by the Multi Disciplinary Team.
The general consensus from the MDT was to remove the breast primary with a lumpectomy, leave the lymph nodes. The Surgeon is a little more keen to go after the lymph nodes as well as she wants to minimise potential disease (potentially only Level 1 auxillary clearance or a biopsy/wire type thingy). Even so, she is very conservative and is very concerned about the things that might cause grief particularly the cording and lymphodema. The Onco was saying, you currently have good local control and shrinkage, leave well enough alone for now til things start moving. I'd have to go off the Ribo's 2 weeks before and after surgery (to allow for immunity to bump back up), then just recommence. He suggested no post surgery radiotherapy in the lymphs to mitigate the lympodema possibility. Everyone has said that I've had had remarkable response with the Ribociclib/Letrozole and there seems to be an element of surprise that I've done so well so far - I didn't have anything to gauge that against, so I will take that as a win :)
In the end, I've said to them, let me enjoy my "happy 3 months" until my next restaging scans. I want to see what further progression (more shrinkage hopefully - fingers and toes crossed) happens. I'll then do a complete round of scans and tests again and we can decide. I'm thinking to get the primary out (yes, get the alien out of me! :) ) as I do get some feedback that there is some evidence to suggest taking that out is a good thing to do. The question will be do we or don't we go for the lymph nodes as well....