Question for Dr. Cianfrocca re: breast cancer treatment - 1257768

cards7up
Posts:636

I know treatment is different. If you're following a 2.5 year patient with stage IV BC with bone mets, is the only way you follow is with the markers? How often would scans be done? Would you use markers only to change treatment? Thank you in advance for your response. Take care, Judy

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Reply # - July 7, 2013, 07:47 PM

Dr West
Posts: 4735

I relayed your questions to Dr. Cianfrocca. I strongly suspect that the answers will require judgment more than a firm, definitive and universal answer, but I suspect Dr. C will be able to provide her own thoughtful approach to these questions.

-Dr. West

Reply # - July 8, 2013, 08:16 AM

dr cianfrocca
Posts: 49

When bone is the only site of metastatic disease, following the disease is very difficult as there is no perfect testing. PET-CT shows some lesions better than a traditional bone scan and visa versa. Also, scans can actually look worse as the disease gets better, further complicating evaluation of response. This is why many clinical trials exclude patients with "bone-only" metastatic breast cancer. Tumor markers can sometimes be helpful however it's not uncommon for them to be completely normal even with widespread bony metastases. I personally try to avoid using an isolated tumor marker rise as a reason to change therapy, particularly in the absence of new symptoms. In terms of how often to do scans, there is no single right answer and the decision is based on many factors including how good the scans are in visualizing the disease, pace of the disease progression in the past, type of therapy the patient is taking, whether the tumor marker is stable, whether there are new symptoms, etc.
All the best,
Dr Cianfrocca

Reply # - July 10, 2013, 02:38 PM

cards7up
Posts: 636

Thank you for your quick response.The response is being tested by markers only and has not had a scan in over 2 years. Tried Xeloda and tumor markers kept rising so switched to taxol (already previously treated before these two). I really don't know anything about breast cancer, but something just doesn't sound right.
Take care, Judy

Reply # - July 10, 2013, 04:15 PM

dr cianfrocca
Posts: 49

While 2 years does seem a bit long, it is difficult for me to definitively comment as I've not been involved in your care. I encourage you to discuss your concerns with your oncologist and if you aren't satisfied with his/her response, a second opinion with another medical oncologist is never a bad idea.

All the best,
Mary Cianfrocca

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