QuestionHello Sir,
Below is case history of a friend who was diagonsed ductal cancer.
# Her cancer is in the milk duct of the left breast - ductal cancer. Of the 3 cysts that were malignant, 2 were big (about 2 cm) and one small. There is no official stage of this cancer… suffice it to say that it is restricted within the duct, although there may be some minimum spread outside the duct.
# This form of cancer usually does not spread easily to other parts of the body, but it does pro-create very rapidly. This explains the quick increase in her cyst size and numbers. But the pro-creation is usually restricted within the cysts.
# The cancer is not a hormonal cancer, which is good because the treatment will not involve tampering with the hormonal production in the body. Hormonal cancers are those that spread by attracting the oestrogen and progesterone cells of the body. The treatment therefore entails curtailing hormonal production. So her treatment will not need that.
# Given her young age (34), the doctors want to pursue the most aggressive form of treatment to be on the safe side. This will include chemotherapy followed by surgery. We don’t know whether the surgery would involve mastectomy or duct-ectomy. This will be determined after few more tests.
# All the above diagnosis is from the general surgeon who operated upon her cysts. This has to be eventually confirmed or corrected by an oncologist.
# She will go through a series of tests in the next 2 days to ascertain several unknowns including the level of spread outside the duct. After these tests the case will be referred to the oncologist who will determine the exact course of treatment.
# Chemo sessions will be administered every other week and she will have anywhere between 4 to 8 sessions, which will be followed by surgery. So we are looking at 2-3 months of treatment.
# She is worried about infertility from the chemo and that is something they will decide on after the tests. If the oncologist determines that there is risk of infertility, they may freeze her eggs prior to the chemo, in which case eventual conception will be through an IVF.
I have following qs if you could please answer:
1. Based on case history is there an alternative less painful treatment to Chemo?
2. If not then are there any precuations/ways of minimizing the pain?
3. What are risks of infertility associated and what are ways to minimize it?
Thanks in advance for all the help and information.
regargds,
Harpreet
AnswerThanks!
1. Unfortunately no, except that I would like also to add radiation therapy to the treatment. Based on size etc. I unfortunately do have to suggest mastectomy. A breast reconstruction (including the nipple) can be made later.
2. Not really, I'm sorry to say, but in the hands of a good surgeon this should not be too big a problem.
3. They are big and you could argue that due to risks to the eggs after chemo there should not be any children afterwards. However, by harvesting eggs from her before treatment (but do not wait long due to this! Time is short & important here!)we get around that problem. She should in that case also consider a host mother for any pregnancies.
Good luck!
