[Hopeful]

Incorrect localization is a common theme in breast cancer. Estrogen receptors get dislocated from the center of the cell to the outside of the cell to join in cross-signaling with Her2 receptors. ER receptors need to be in the cell nucleus for Tamoxifen to work. This is one of the means by which Her2+ bc is resistant to Tamoxifen treatment. Here, the sodium-iodide symptomer is disclocated in the breast tumors, making the cells resistant to taking up iodide, so it is likely that they will be resistant to radioactive iodine treatment.

I think our entire discussion harkens back to the basic premise that breast cancer is an endocrine disease, and involves the entire endocrine system, all of which is delicately balanced within some relatively narrow parameters. It is impossible to isolate parts of the system for treatment; the system as a whole needs to be addressed. My kingdom (or at least my house) for an endocrinologist who can appreciate this and steer research and treatment, to help us all better understand the interrelationships of this fascinating part of our bodies.

Hopeful