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Do you need Chemo to battle Metaplastic Breast Cancer?
Can you treat metaplastic breast cancer with only radiation?
• It is often stated that chemo does not work with metaplastic breast cancer (MBC). However, it is given as the strongest possible deterrent to reoccurrence after surgery. This case study aims to detail the scenario of a 70 year old woman who declined conventional treatment for metaplastic breast cancer.
• The 70 year old female was offered a radical mastectomy, chemotherapy (FECx6) and radiation. Instead she only had radiation.
Patient History
i. T2, N0 metaplasticbreast carcinoma was found on the right breast.
i. Another 2mm lobular carcinoma was also found.
i. The mass was Triple Negative and slightly KI67 positive.
The patient discovered a mass on her breast in May 2011. The original mass was 1.9cm but it grew to 3cm by July 2012 when it was biopsied. The mass was originally considered to be a cyst. It was removed in September 2011. Following removal came radiation therapy for one month. The patient refused her doctor’s advice and did not have chemotherapy.
July 2011 Nov 2011 March 2012 2012May 2011 2013
Found a lump
Solid lump found by patient in May 2011. Visited family doctor.
Removal of tumour
TNBC, KI67 +, MBC spindle cell plus 2mm lobular carcinoma
Cancer free
The patient was cancer free for the whole of 2012
Biopsy
Due to ultrasound and mammogram mass considered threatening with sarcomatoid features
Radiation
40GY of radiation therapy completed.
New possible Cancer found in the leg. A mass growing outside of the leg resembling a boob with a nipple
CANCER TIMELINE – Metaplastic Breast Cancer Spindle Cell
http://www.metaplasticbreastcancer.net
http://www.benaroberts.com
Lymph Node (0/5)
HER2 Negative
Radiation Treatment Plan
See Above 40 GY
BRCA Negative
2 completely different types of cancer
MBC and Lobular
2012201220112011
Timeline in 2011
Course ID Plan ID RX Dose Fraction
1R + Breast RT Boost 10 5/5
1R+ Breast RT Boost 40 15/15
Image of Breast Scar
New Cancer found in 2013
• The patient was cancer free for one year. • Found a suspicious lesion on her right calf in January 2013
which was dismissed by her doctor. The lump continued to grown and was a mass outside of her skin. In September she was initially diagnosed as a metaplastic lesion.
• Examination – 2x1.5cm erythematous nodule over the medial aspect of the right calf.
• Diagnosis – after operation and removal in December 2013 - cystic lesion right leg with squamous cell carcinoma in situ with a cyst wall.
• According to her medical team there was no evidence of any relation to the old cancer.
Sept 2013 Dec 2013 Dec 2013 2013Jan 2013 2014
Found new lesion on leg of 72 year old female patient with history of MBC
Removal of tumour
Due to previous cancer quick removal of new lesion
No treatment
Patient opted out of all treatment for new cancer
Patient went for an ultrasound and was treated quickly
Diagnosis: 2x1.5 cystic lesion with squamous cell carcinoma in Situ with a cyst wall.
Cancer Free
The patient is currently cancer free
CANCER TIMELINE – Squamous Cell Carcinoma in Situ
Http://www.facebook.com/metaplasticbc
http://www.facebook.com/metaplasticbreastcancer
Image of leg scar
Medics state that there are no similarities between both cancers but there are similarities that cannot be dismissed
All cancer was on the right side of the body. Both cancers were originally perceived to be cysts. One cancer was treated slowly and grew to include a whole new cancer (lobular) on removal – despite
showing large cells at biopsy.
Her original pathology shows Spindle Cell and her new cancer is Squamous – both are sub-types of MBC. Furthermore,
crystallised forms of tumour were discovered but were not tested. The first cancer had a chance to grow and was more aggressive. The second cancer had a change to grow from 0-2cm but wasn’t biopsied. The cyst that was profiled showed
Suamous elements hance her diagnosis. This means that new growth patterns could not be assessed.
Conclusion
• Even though doctors disagree. We believe that there are some similarities between the patients cancer. Her leg biopsy was botched despite showing crystallised formations that resemble a metaplastic tumour.
• But, this is overshadowed, by the fact, that the lady despite an aggressive diagnosis has survived MBC with only one reoccurrence. This is without doing chemotherapy. This must show a positive outcome for patients with a similar T2, NO diagnosis.
• In 2014 the lady is alive and well with no existing cancer. Current medication includes Statin and Pantropozole.
Quick synopsis of 6 known patients that chose radiation only
Two women Squamous Grade 1 MBC one 1.5 years
cancer free and one 4 years cancer
free
Carcinocarcinomapatient with
radiation only. Reoccurrence and mets. Deceased.
Our 70 year old case study with
Squamous and 1 similarly aged
woman with Grade 2 MBC – 1 year
cancer free
52 year old woman – undisclosed
details
With only six women we know of that have chosen only radiation: mere assumptions can be made. Low grade MBC (under 2A) and no lymph nodes can be treated with radiation after surgery. Four women have had success.However more aggressive tumours (above 2b) should be treated more aggressively. However, a reoccurrence did occur in this case and maybe chemo would be the preferred choice for a cancer free future.
BENA ROBERTSWWW.BENAROBERTS.COMWWW.METAPLASTICBREASTCANCER.NET
Please contact me: [email protected]
We are actively looking for a PhD student or similar to analyse our data
