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Old 04-25-2012, 04:03 PM   #1
chrislmelb
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Micro Bone Mets-Treatment?

Hi girls, i probably have multiple bone mets which are on a bone scan but not Xrays. They are in multiple places but obvisiouly still very small. I am just wondering what the current course of treatment tends to be 'over there'? I am thinking they will probably just change my AI and add Zometa. Just wondering if they will throw Herceptin into the mix as well?
Any information appreciated.
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Christine

DX Sept 03 age 40 Stage 2B Grade 3 mastectomy (after 2 prior breast conserving surgeries)
"at least" 2.3 cm 3/12 nodes ER+/PR+ Her2+++
8 FEC. Tamoxifen then Arimidex. Ovaries out.
"late" Herceptin for 2 years (18months after chemo) on HERA trial. finished Herceptin Nov 2007.
Multiple bone mets May 2012 and now liver August 2012.
Abraxne, Herceptin and Zometa.
June 2013 Tykerb, Xeloda and Xgeva
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Old 04-26-2012, 01:19 AM   #2
Mandamoo
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Re: Micro Bone Mets-Treatment?

Hi Chris
Sorry to hear that you may have bone mets. I think we met at a forum earlier this year.

I thought with denosumab's approval you might be put on that straight away? I have just been diagnosed with osteoporosis and my onc was even talking about denosumab for that.

Do you think your Onc will restart herceptin? It seems most if not all of us at Stage 4 have either herceptin or tykerb included in our regime regardless of hormone status.

I hope you are doing ok - I am sure you will get some more responses from the girls who know heaps more than me.
Sending you love,
Amanda
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Amanda xx
40 year old Mum to three gorgeous kids - son 5 and daughters 8 and 11
Wife to my wonderfully supportive husband of 17 years!
22 February 2011 - Diagnosed Early Breast Cancer IDBC Stage2b (ER/PR -ve, Her2+ve +++) - 38 years old
(L) skin sparing mastectomy with tissue expander, axilla clearance (2/14 affected) clear margins.
Fec*3, Taxotere and herceptin*2 - stopped due to secondary diagnosis

June 24 2011 Stage IV - Skin met, axilla node, multiple lung lesions

Bolero3 trial - Navelbine, Hereptin weekly, daily Everolimus/Placebo
February 2012 - July 2012 Tykerb and Xeloda - skin mets resolved, Lungs initially dramatically reduced but growing again
August 2012 (turn 40!) tykerb and herceptin (denied compassionate use of TDM1) while holidaying in Italy!
September 2012 - January 2013 TDM1 as part of the Th3resa trial - lymph nodes resolved, lungs slowly progressing.
January 2013 - herceptin, carboplatin and Perjeta (compassionate access)
April 2013 - Some progression in lungs and lymph nodes - Abraxane, Herceptin and Perjeta
July 2013 - mixed response - dramatic reduction of most lung disease, progression of smaller lung nodules and cervical and hilar nodes - ? Add avastin.

Last edited by Mandamoo; 04-26-2012 at 01:19 AM.. Reason: perception "virus" lol!
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Old 04-26-2012, 10:42 AM   #3
Lani
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Re: Micro Bone Mets-Treatment?

In the best of all possible worlds, a bone marrow or bone biopsy might be standard of care to determine if what is lighting up on the bone scan (which could be tumor, microfractures or infection) is indeed tumor and whether it is or isn't her2+. Not all her2+ tumors metastasize as her2+, although the vast majority do.

I would be nice if you had a clinical trial in your neck of the woods in which they were trying to biopsy these lesions. You did not say where they were--some areas of bone are weightbearing so if a larger biopsy of bone were performed you might have to be on crutches afterwards (Never for a bone marrow test).

I have no knowledge of it being state of the art here EXCEPT at every conference I go to they say that clinicians should try to biopsy every metastasis to determine its ER,PR and her2 status and be sure it hasn't changed. Don't know if that changes government pollcies and how much leeway your treating doctors might have

Sorry to ramble--am not sure I have contributed much helpful but you can quote me as one who attends the AACR, ASCO and San Antonio meetings yearsly as well as ASCO breast and AACR breast when they occur as having heard the underlined voiced emphatically at every meeting.
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Old 04-26-2012, 01:16 PM   #4
tricia keegan
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Re: Micro Bone Mets-Treatment?

Hi Chris, my friend had bone mets and was given herceptin and also switched to Faslodex and zometa which she had a great response to, at that time she had some bone pain so rads took care of that but the mets were obviously more advanced than yours, good luck!
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Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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Old 04-26-2012, 03:59 PM   #5
chrislmelb
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Re: Micro Bone Mets-Treatment?

Thanks girls, keep it coming. Lani the mets are lumbar, thoracic, ribs and maybe spot on skull. I will push for a biopsy.
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Christine

DX Sept 03 age 40 Stage 2B Grade 3 mastectomy (after 2 prior breast conserving surgeries)
"at least" 2.3 cm 3/12 nodes ER+/PR+ Her2+++
8 FEC. Tamoxifen then Arimidex. Ovaries out.
"late" Herceptin for 2 years (18months after chemo) on HERA trial. finished Herceptin Nov 2007.
Multiple bone mets May 2012 and now liver August 2012.
Abraxne, Herceptin and Zometa.
June 2013 Tykerb, Xeloda and Xgeva
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Old 04-26-2012, 04:14 PM   #6
Mandamoo
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Re: Micro Bone Mets-Treatment?

Chris - I have just found out about a Breacan talk on the 10th May by Richard de Boer in the latest in Bone treatment and prevention in BC. It is booked out but it has been suggested to me that if you turn up on the day you will not be turned away. I am thinking of going. I thought you might me interested.
A x
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Amanda xx
40 year old Mum to three gorgeous kids - son 5 and daughters 8 and 11
Wife to my wonderfully supportive husband of 17 years!
22 February 2011 - Diagnosed Early Breast Cancer IDBC Stage2b (ER/PR -ve, Her2+ve +++) - 38 years old
(L) skin sparing mastectomy with tissue expander, axilla clearance (2/14 affected) clear margins.
Fec*3, Taxotere and herceptin*2 - stopped due to secondary diagnosis

June 24 2011 Stage IV - Skin met, axilla node, multiple lung lesions

Bolero3 trial - Navelbine, Hereptin weekly, daily Everolimus/Placebo
February 2012 - July 2012 Tykerb and Xeloda - skin mets resolved, Lungs initially dramatically reduced but growing again
August 2012 (turn 40!) tykerb and herceptin (denied compassionate use of TDM1) while holidaying in Italy!
September 2012 - January 2013 TDM1 as part of the Th3resa trial - lymph nodes resolved, lungs slowly progressing.
January 2013 - herceptin, carboplatin and Perjeta (compassionate access)
April 2013 - Some progression in lungs and lymph nodes - Abraxane, Herceptin and Perjeta
July 2013 - mixed response - dramatic reduction of most lung disease, progression of smaller lung nodules and cervical and hilar nodes - ? Add avastin.
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Old 04-26-2012, 04:21 PM   #7
chrislmelb
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Re: Micro Bone Mets-Treatment?

Thanks Amanda, it must be listed in their advanced section cos i can't find it on 'normal' one. They know me at Breacan and i will sit on the floor!!
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Christine

DX Sept 03 age 40 Stage 2B Grade 3 mastectomy (after 2 prior breast conserving surgeries)
"at least" 2.3 cm 3/12 nodes ER+/PR+ Her2+++
8 FEC. Tamoxifen then Arimidex. Ovaries out.
"late" Herceptin for 2 years (18months after chemo) on HERA trial. finished Herceptin Nov 2007.
Multiple bone mets May 2012 and now liver August 2012.
Abraxne, Herceptin and Zometa.
June 2013 Tykerb, Xeloda and Xgeva
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Old 05-01-2012, 06:59 AM   #8
KakaCathFreeSpirit
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Re: Micro Bone Mets-Treatment?

Hi christine, holly-crap Im so sorry to hear where you are right now, but your onto it early so thats good, when did you find out ? the Rick De Boer BreaCan talk will be good, he is also head Onc with the Trial Im on and been pestering the RMH research nurse to see him, got the bone/mineral clinic tomorrow, any chance your in the same fascinity as well ?. I logged on today by coincidence looking for some updates on TDM-1, take care darl xo
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IDC x1, 2cm, DCIS x2, ER-PR- HER2++ 5/24 node+ grade 2, stage 2b, mastectomy x2, right-prophylactic, axillary clearance, chemo, rads x25, herceptin x18, neratinib clinical drug trial daily x1yr till Aug 2012, a mono-therapy phase II trial, to study brain mets prevention !
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Old 05-01-2012, 03:52 PM   #9
chrislmelb
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Re: Micro Bone Mets-Treatment?

Hi Catherine, i have emailed you. I am at RMH Thursday 11.30.
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Christine

DX Sept 03 age 40 Stage 2B Grade 3 mastectomy (after 2 prior breast conserving surgeries)
"at least" 2.3 cm 3/12 nodes ER+/PR+ Her2+++
8 FEC. Tamoxifen then Arimidex. Ovaries out.
"late" Herceptin for 2 years (18months after chemo) on HERA trial. finished Herceptin Nov 2007.
Multiple bone mets May 2012 and now liver August 2012.
Abraxne, Herceptin and Zometa.
June 2013 Tykerb, Xeloda and Xgeva
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Old 05-01-2012, 03:57 PM   #10
chrislmelb
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Re: Micro Bone Mets-Treatment?

Amanda i have emailed you too.
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Christine

DX Sept 03 age 40 Stage 2B Grade 3 mastectomy (after 2 prior breast conserving surgeries)
"at least" 2.3 cm 3/12 nodes ER+/PR+ Her2+++
8 FEC. Tamoxifen then Arimidex. Ovaries out.
"late" Herceptin for 2 years (18months after chemo) on HERA trial. finished Herceptin Nov 2007.
Multiple bone mets May 2012 and now liver August 2012.
Abraxne, Herceptin and Zometa.
June 2013 Tykerb, Xeloda and Xgeva
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Old 05-09-2012, 02:27 AM   #11
chrislmelb
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Re: Micro Bone Mets-Treatment?

My mets were confirmed and i have multiple mets all around torso. I have been put on Herceptin, Zometa and back to Tamoxifen, together with lots of pain meds. Lani i read your statement re biopsy but my onc said it was too hard to pin point to get a correct sample.
Thanks for your help.
__________________
Christine

DX Sept 03 age 40 Stage 2B Grade 3 mastectomy (after 2 prior breast conserving surgeries)
"at least" 2.3 cm 3/12 nodes ER+/PR+ Her2+++
8 FEC. Tamoxifen then Arimidex. Ovaries out.
"late" Herceptin for 2 years (18months after chemo) on HERA trial. finished Herceptin Nov 2007.
Multiple bone mets May 2012 and now liver August 2012.
Abraxne, Herceptin and Zometa.
June 2013 Tykerb, Xeloda and Xgeva
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Old 05-13-2012, 09:55 PM   #12
Pamelamary
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Re: Micro Bone Mets-Treatment?

Hi Chris,
Were you at Rick de Boer's talk? He organised a bone biopsy for me when I saw him for a second opinion and was very convincing about their value. However I am aware that it can be hard to do when your lesions are very small or in awkward positions. I am at Peter Mac and currently on T-DM1 and Zometa, (and perhaps Pertuzamab)
Best wishes to you..... Pam
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Old 05-13-2012, 09:59 PM   #13
Mandamoo
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Re: Micro Bone Mets-Treatment?

Good Info Pamela
Chris and I were both at Ric DeBoer's talk - did you go too? I found it very useful to understand the current treatments. I feel more equipped now to go see an endocrinologist about my osteoporosis.
__________________
Amanda xx
40 year old Mum to three gorgeous kids - son 5 and daughters 8 and 11
Wife to my wonderfully supportive husband of 17 years!
22 February 2011 - Diagnosed Early Breast Cancer IDBC Stage2b (ER/PR -ve, Her2+ve +++) - 38 years old
(L) skin sparing mastectomy with tissue expander, axilla clearance (2/14 affected) clear margins.
Fec*3, Taxotere and herceptin*2 - stopped due to secondary diagnosis

June 24 2011 Stage IV - Skin met, axilla node, multiple lung lesions

Bolero3 trial - Navelbine, Hereptin weekly, daily Everolimus/Placebo
February 2012 - July 2012 Tykerb and Xeloda - skin mets resolved, Lungs initially dramatically reduced but growing again
August 2012 (turn 40!) tykerb and herceptin (denied compassionate use of TDM1) while holidaying in Italy!
September 2012 - January 2013 TDM1 as part of the Th3resa trial - lymph nodes resolved, lungs slowly progressing.
January 2013 - herceptin, carboplatin and Perjeta (compassionate access)
April 2013 - Some progression in lungs and lymph nodes - Abraxane, Herceptin and Perjeta
July 2013 - mixed response - dramatic reduction of most lung disease, progression of smaller lung nodules and cervical and hilar nodes - ? Add avastin.
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Old 05-14-2012, 05:07 AM   #14
Pamelamary
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Re: Micro Bone Mets-Treatment?

Hi Amanda,
Yes, I was - funny isn't it? Actually I am a volunteer at Breacan, though not "working" just now. Also found it helpful, as many of their sessions can be.
Regards.... Pam
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