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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Treatment Of Breast Cancer ?

Need a breast surgeon regarding a new cancer in the same breast, where I had a lumpectomy eight years ago. Previous treatment included chemotherapy and radiation, followed by tamoxifen for two years only. I live in Victoria. This new cancer is very early stages (cells), not visible on an ultrasound but picked up on a yearly check up mammogram. Have had a static core biopsy under mammogram, bone scan and Ct scan. These tests confirmed that there is no nodal spread or metastatic disease. The biopsy report stated R breast lateral calls, core biopsies - high-grade ductal carcinoma in situ with comedonecrosis; one very tiny focus of infiltrating carcinoma (ER+, PR-, HER-2 2+) . Would like a second opinion on how to treat this new finding.
Wed, 10 Dec 2014
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Oncologist, Surgical,  's  Response
The best treatment for you would be to undergo a mastectomy (removal of the entire breast) followed by chemo and/or radiotherapy if required, based on the final histopath report. The reason i say this is manyfold. First, you have had a recurrence in the previously treated breast which means that your breast tissue is prone to recurrence. Second, you have ductal carcinoma in situ the extent of which is difficult to ascertain on mammogram or by naked eye. If left behind, this can cause cancer later. Third, there is a focus of invasive carcinoma in the core biopsy specimen. For all these reasons, a mastectomy in my opinion would be the best option.
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What Is The Treatment Of Breast Cancer ?

The best treatment for you would be to undergo a mastectomy (removal of the entire breast) followed by chemo and/or radiotherapy if required, based on the final histopath report. The reason i say this is manyfold. First, you have had a recurrence in the previously treated breast which means that your breast tissue is prone to recurrence. Second, you have ductal carcinoma in situ the extent of which is difficult to ascertain on mammogram or by naked eye. If left behind, this can cause cancer later. Third, there is a focus of invasive carcinoma in the core biopsy specimen. For all these reasons, a mastectomy in my opinion would be the best option.