Re: Breast cancer

From: Atkinson, Samuel M (ATKINSONS@mail.ecu.edu)
Fri Oct 28 11:55:45 2005

My answers to your questions.

1.The classically quoted doubling time for breast cancers is 4 mos. Allowing for 5 mos and statistical variation, a 2 mm lesion can well be hidden from view. In 5 mos it will be 5-6 mm and visible. When a cancer is detected, it has probably been present for 5-7 years, a piece of information the WHI people ignored for publicity sake or ignorance. Thus the positive nodes at surgery.

2Yes.. Her chemRx. May be delayed a week or to to allow the wbc to recover or marrow stimulants can be given.

3. The main difference is cost. Tamox is off patent and generic. Arimedex is the opposite and terribly costly. The data shows a slight improvement in survival with Arimedex but the question of cost vs benefit is unsettled. They are both estrogen receptor modulators. The data does show an increase in survival after five years on Tamox, stopping it and then adding Arimedex. There is no advantage to more than five years on Tamox. 4. Hope this helps. By the time breast cancer is detected it is already a systemic disease in most people opinion..thus the recommendation for irradiation locally and systemic chemo. 5. MRI is a better detector of breast cancers but cost is prohibitive except in high risk/familial ca pts. Finding out if one had the gene is probably money better spent than routine MRI's of breast. 6. Sam Atkinson

________________________________

From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of 

--
________________________________
GA12L@aol.com
Sent: Friday, October 28, 2005 4:22 AM
To: Multiple recipients of list OB-GYN-L
Subject: Breast cancer


My mother had a mamogram in January this year which was clear.  End of
May she found a thickening of the skin and went to see GP.  She then had
another mamogram and a biospy that revealed invasive lobular breast
cancer. She had a mastectomy they took 8 lymph nodes and found cancer in
the first 4 but not in the last 4. She's now having 6 sessions of chemo
(she's now had 4 as of yesterday) she will then have 4 weeks of
radiotherapy and then arimidex for 5 years.


What I want to know is why didn't the mamogram pick the cancer up in
January or is it possible for it to have developed and grow so big in 5
months?


Her white cells are now 2.2 will she be able to complete her last 2
courses of chemo?


What is the difference between Tamoxifen and Arimidex?


Will my mum be okay?


Thanks,


Gail



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