For attention of : ONCOLOGIST or ONCOSURGEON.
Dear Doctor,
I’m a 54 year old male.
I had a lump in my right breast since over 2 years which was found to be ‘Invasive Duct Carcinoma (NOS) Grade-1’, upon FNAC Biopsy done recently on 1st August.
Subsequently done CE CT chest Scan confirmed that the decease had not spread to other parts of body. However, the report also mentioned that :
“few tiny non-enhancing hypodense lesion seen in liver. Size of largest one is approximately 1.2 x 1.0 cms. These lesions represents probably benign cysts. There is subtle peri-nephric fat stranding noted on both sides.”
Finally, I was operated on 4th August for ‘Right Modified Radical Mastectomy’ and its Microscopy and Diagnosis revealed :
-     Invasive Ductal Carcinoma, (Right breast, Central quadrant)
-     Histologic grade II; (RB score : 2+3+1)
-     Maximum tumor diameter is 2cm
-     No unequivocal lymphovascular invasion is detected.
-     Invasive carcinoma involves nipple by direct extension.
-     Nipple ducts are also involved by intraduct carcinoma.
-     Resection margins are free.
-     Axillary nodes : All Twenty-two nodes are free of metastasis (0/22)
-      pTNM stage : pTlc pNo Mx (Path stage : I).
Further, test result of Microscopy and Diagnosis of ‘Right side Axillary Node’ said
Two negative nodes (0/2).
IHC Profile mentioned
1)     Estrogen Receptor     : Positive (+++), in almost 100% of tumor cell nuclei.
2)     Progesterone Receptor     : Positive (+++), in almost 100% of tumor cell nuclei.
3)     CerB2               : Negative
4)     E-Cadherein          : Positive
5)     Ki-67               : Approx. 30%
According to the Surgeon, Radiotherapy or Chemotherapy was not needed.
The medicines prescribed were only Anti-biotic , B12 and multi vitamin.
I’v been advised to take rest and avoid travelling for 4-5 weeks.
There were around 40 stitches on the chest which were removed after 3 weeks.
My problem is :
1.     There is unusual hard / stiffness feeling in the operated area of chest as well as right under arm portion. (in pectoral major and biceps brachi muscles ????)
2.     There is also feeling of numbness in the operated area of chest as well as inner portion of upper right arm.
3.     Movement of the right arm towards upper side is restricted upto 70 to 75 % of what normally it should be or compared to left arm. It pains upon stretching.
Will you please suggest :
1.     What should I do to get rid of above problems ?
2.     What precautions should I exercise to avoid reoccurrenceof Cancer in future ?
3.     Will any type of massage or heating pad help to smoothen the functioning of right arm / muscles ?
4.     Are the non-enhancing hypodense lesion (probably benign cysts ) seen in liver harmful and need any treatment ?
Please note,
I don’t smoke or drink alcohol or consume Tobacco in any form.
I never had any ailments like Diabetes, Blood pressure etc.
All my clinical tests of Hematology, Biochemistry, Serology, Urine analysis, Echo / Stress etc. were well within normal range in past as well as before the Surgery. Detailed test reports can be furnished, if needed.
Will you please revert ?
Thanks.
Pankaj Taparia
e-mail : YYYY@YYYY