[chrisy]

Hi Dee,

Sorry to hear you got some bad news - just as you were maybe starting to feel you could put breast cancer behind you. I can sure relate to that. Of course you're terrified, who wouldn't be!

Do not lose heart. This is a frightening diagnosis, to be sure, but it is not necessarily an immediate death sentence. There are many treatment options which can work well and for a long time. It's time to put on the armour and gear up for the fight!

You didn't mention details of your original pathology, except I assume Her2+++ as you were getting Herceptin. What about ER/PR? How was this discovered - did you have symptoms?

As for advice...

First, yes you do want to get the full range of tests - bone, brain MRI, and CT or PET to confirm what you're dealing with. Are they even certain this is cancer?
Next, I would strongly suggest you get a biopsy of the liver lesion to determine if it is mets from the breast cancer not a different cancer, which would call for different treatments. Even if it is mets, you want to know the "profile" of the tissue - ER/PR/Her2, etc as this would impact treatment options and may have changed since your original diagnosis.

Depending on what is learned through these tests (if it is confined to the liver) you may be eligible for local treatment - surgical resection or radio-frequency ablation or cryoablation - that is, removal/destruction of the liver tumor directly. There have been several small studies showing long term survival benefit in breast cancer with liver-only mets. It's not standard protocol, but may be an option.

If these options are not viable (size/location of tumor, etc.) there are still conventional (chemo) treatments that can be effective. You may or may not be taken off Herceptin. My onc has said to me that "sometimes there can be renewed synergy when you add chemo and continue Herceptin" So this may be an option.

Or, you may be eligible for a Tykerb trial - there are several out there for patients in whom Herceptin is no longer effective. There are several ladies on the board who are on trials or the early access (EAP) program doing well with Tykerb/Xeloda.

I'm sure you'll get lots more encouragement from others on this board. There are a lot of very smart folks here who can help you take up the fight.

Take care
chris