Ask an Expert: View a Question - Questions to ask to ensure you are in good hands

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	Questions to ask to ensure you are in good hands Questions on what to ask to make sure your in good hands.	1,753

Asked	Publicly Submitted Question
12/14/2011	Hi, my wife was diagnosed with Breast Cancer, she opted for bilateral mastectomy as she had dense breasts with multiple calcifications some of them "lineal". Mammo, Ultrasound and MRI showed lump ONLY in left breast. Surgery Dic14th 2010 According with pathologycal report, there were an Invasive Ductal Ca (2.5x2.7cm)Grade III(Nottingham), Triple Negative, CK5/6(+),EGFR(+), Ki67 40%, p53(+)+ DCIS with retrograd lobulillar cancerization in Left Breast. Centinel Node NEGATIVE 0/1(tested with patent blue) In the Right breast the path. found another IDC (0.4cm)Grade III + DCIS. Centinel node Negative 0/2. On februry she had a second surgery as left prosthes was exposed due to skin damage (she is allergic to Tegaderm or any kind of hipoallergenic strip) and had to be removed previous "empiric" antibiotic treatment for two months without ANY sign of infection and NEGATIVE cultures. On April her Onc asked for CT scan + Bone Scan both of them NEGATIVE. On May she noted three lumps in axillary region + another in mammary region. We asked for Ultrasound by ourselves finding these nodes were enlarging about 100% in a month. Had another surgery on July. Path report informed three nodes in axillary region which might be invaded limph nodes and two more in mammary region were the same histological kind IDC NST Grade III,Triple Negative, CK5/6(+), Ki67 60%.The rest of axillary nodes 0/9 were Negative. We Asked for a second pathologist report and he informed the three were invaded axillary limph nodes with the same histologiacal grade, Triple negative, CK5/6(Negative),EGFR(+), Ki67 40%, p53(+)90%. About 20 days after third surgery, my wife discovered another 4 lumps in the same region where the previous were, three in the axillary region and one in the surgery scar... All of them, continued enlargening besides 4 cicles of Capecitabine. We asked the onc for a new scan (CT+ bones scan) and he said they weren´t neccessary (the last and unique scan was done on April...) nor a needle biopsy, nor cchemo sensitivity test. She began with Radiotherapy only on the left breast and continued with Capecitabine. Onc "forgot" to mention that we had to wait until 6 months from the end of the rdt. due to the risk of "false positive" results i the whole area including lung area. I´m a physician, my wife is biochemist working on genetics and we think Capecitabine it´s not working. Up until now we consider the onc as quackery... I would like to know your professional opinion about the whole treatment and what do you think we have to do.after reading DR Richard Zellars work in raditherapy and citokeratines and p53, which i consider a great porffesional, and DR Leisha Emens work i was considering traveling to USbefore asking her opinion on Dendritic cells vaccinations. but that is not our area as she is an oncologist working too in inmunotherapy.I have had the pleassure meeting DR stainman while hisfindings were a work in progress.I'm ver sorry for the long history but i need guidance at least this is a I thank you in advance
Replied	JHU's Breast Center Reply
12/15/2011	Given the complexities of your wife's clinical situation, it sounds worthy of your time and effort in having you both come for a second opinion consultation here. we are not able to do recommendations via internet postings of this kind as it requires our re-review of the pathology slides as well and a great deal more medical information obtained and of course a clinical exam as well. to pursue this with us call 410-955-8964.

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