Breast cancer: surgery, chemo radiotherapy – cancer spread to liver and bone
Dear Prof Teo,
My mother is 60 years old Chinese lady with background history of left breast carcinoma diagnosed in 2003. She had undergone left mastectomy with axillary clearance in Hospital Perdana, Kota Bharu in 2003. HPE revealed infiltrating lobular carcinoma. She then had completed 25 cycles of radiotherapy in HUSM, Kota Bharu, Kelantan.
She was apparently well until presented to HUSM on 2007 with gross ascites and had undergone several times of peritoneal tapping. CT scan done in November 2007 showed gross ascites and circumferential bowel wall thickening at cecal region and barium enema study was done. However, a barium enema procedure was abandoned due to laxed anal tone. Colonoscopy result also was sub-optimal. Features suggestive of liver metastasis noted from ultrasound done on 7th Jan 08.
She then was scheduled for chemotherapy (CEF),started on 28th Jan 2008 and had completed 6th cycles of Chemotherapy. She then was well until in April 2009 when she presented to HUSM again with abdominal pain associated with loss of appetite, nausea, vomiting, bloated and loose stool. OGDS done in 20th April 2009 and the findings were:
Swollen edematous whole stomach,D1 and D2.Biopsy result is consistent with diffuse adenocarcinoma. Repeat CT scan on 3rd May 2009,showed gross ascites, fatty liver with multiple cystic lesions in segment III and IV (which may represent cystic metastasis) and lytic lesion in the right iliac crest(which is possible of metastasis).
Mother was not keen for any surgical intervention and chemotherapy. Apart from that, she also is a known case of pangastritis with multiple gastric ulcers. Her current medications are T.Spironolactone 75mg BD,T.Nexium 40mg bd,Vitamin supplements and hematinics.
My Aunty introduced us to pay a visit to your centre in Penang.