Newly discovered metastatic disease in breast cancer – a personal view of the treatment options
By Anne Hayden, PhD
BCAC member Anne Hayden shares her treatment story to highlight that there may be alternatives to the usual options of palliative chemo and radiotherapy when newly discovered breast cancer metastases are found.
This is a brief note to let women and men with newly discovered breast cancer metastases in the lung know of my experience. I was diagnosed with HER2 positive breast cancer in November 2004 and treated with the usual surgery, chemo, radiotherapy and later, 6 months of Herceptin. In August 2007 I was diagnosed as having an unrelated choroidal (retinal) melanoma in my right eye, which was treated with a radioactive implant for over 48 hours. So, I now have a general oncologist, Dr Paul Thompson, and an eye oncologist, Dr Peter Hadden.
In November 2009, just 10 days before my five year anniversary of the initial breast cancer diagnosis, a single small symmetrical lesion was discovered in the base of my right lung. Paul Thompson thought, because of its size and symmetrical appearance that it looked like a melanoma secondary (not secondary breast cancer). Breast cancer usually relapses at multiple sites, not just in one place and most recurrences of HER2 positive disease occur within 18 months of surgery rather than five years down the track, further suggesting that this was unlikely to be breast cancer. Dr Thompson explained that surgical excision was an option for me because this is the best treatment for most recurrent melanomas. Breast cancer metastases are normally treated with chemotherapy, with any lesions left in situ, i.e. they will not be surgically removed. Given this information, my husband and I decided to pursue surgery, a (R) wedge resection (thoracotomy) of my right lung, to have it removed. I was referred to a cardiothoracic surgeon. Surprisingly, the histology showed it was HER2 positive breast cancer.
It is now two and a half years since this happened, and in the last three months I have had a MRI of my brain, a chest X Ray and an upper abdominal ultrasound, all of which have been CLEAR. I, my family and Paul Thompson are amazed that there has (touch wood) been no recurrence to date. He says to us at every visit how pleased he is that we had the lesion surgically removed.
I wanted to share this with other breast cancer sufferers who might find themselves in a similar situation without the history of a retinal melanoma. This is because my experience strongly suggests that if a single breast cancer lesion is found then there may be an argument for its excision to be considered alongside the usual options of palliative chemo or radiotherapy. So, if you find yourself in this situation, with a recurrence of breast cancer in the form of a single lesion, say on your lung, you might like to ask your oncologist whether surgical removal might be a good option for delaying the advancement of your cancer.