Bad Pet. I need you.

[gdpawel]

Michka

The fact that your doctor would like a biopsy of a node is a positive step in the right direction, instead of more trial-and-error treatment. Tumor hormone-receptor and Her2 status can change in breast cancer patients during the course of their disease, and these changes can significantly influence survival and can completely change the patient's clinical management. Results of a 2011 European Multidisciplinary Cancer Congress study showed that there is substantial tumor instability during tumor progression.

How and what type of chemo test your doc has in mind, may have some bearing in the matter. The slides from your last liver resection may not have any affect in testing on what may be your disease now. There is the issue about cell-lines (slides) vs fresh cells. Cell-lines have always played an important role in drug screening and drug development. The problem is that cell-lines do not predict for disease or patient specific drug effects.

As a general rule, studies from established cell-lines (tumor cells that are cultured and maniplated so that they continue to divide) have not be very successful as models to predict the activity of drugs in cancer. An established cell-line is not reflective of the behavior of fresh "live" tumor samples (like from the node) in primary culture, much less in the patient. You will get different results when you test passaged cells (from cell-lines) compared to primary, fresh tumor.

My thoughts would be, do you want to utilize your tissue specimen for drug selection against your "individual" cancer cells or for mutation identification to see if you are "potentially" susceptible to a certain mechanism of attack?

Best of luck!

Greg

[StephN]

Dear Michka -
We are not happy to hear that you have those new issues to deal with. But I do like the fact that your onc wants another scan (what kind?) next week to coroborate this last one that is throwing you for a loop.

Was also thinking about a biopsy since you may have some tissue that can be gotten at for analysis. I imagine he would want the slide from your liver to compare with a new tumor biology.

There are many ways to go at these tumors, just as soon as your doctor is sure about what the scans say.

If you try for T-DM1 before you have had some other drugs, it may disqualify you from their use in future. Try to check the drug ladder for the new drugs and trials.

Certainly you feel bad for causing pain to those closest to you, but they are there for you and know that you have been fighting the NERDy cancer with all you have.

Hugs and bises.