Bless!
首先祝福全家，勇敢面对。The course is challenging but I believe your wife
definitely can go through, with the whole family's support. The management
of side effects of chemo makes it more tolerable now.
Wait for the pathological report first. Certain type breast cancer, such as
mucinous adenocarcinoma, has a better prognosis as it is less aggressive and
responding to chemo well.
Currently, we treat breast cancer with multimodality measures. Local therapy
with surgery and radiation therapy plus systemic treatment with chemo,
endocrine therapy and targeted therapy.
You have to talk with your medical oncologist about refers to surgical
oncology and radiation oncology for local treatment at some point.
When you look at the path, pay attention to hormone receptors. If Estrogen/
progesterone receptor positive, patients are qualify for endocrine therapy
with either tamoxifen (in your wife's situation as she is premanopause) or
aromatase inhibiors (postmanopause) such as exemestane, letrozone or
anastrezole. For very early stage of breast cancer (ductal carcinoma in situ
/DCIS or lobular carcinoma in situ/LCIS), this treatment is enough.
When the cancer cells express HER2/neu, which happens in 25% of breast
cancer, suggesting more aggressive cancer. Previously, this is an
unfavorable marker. But now, we have tools targeting at HER2, such as
Herceptin, which makes the treatment efficacy for this type of cancer
dramatically better.
If triple negative (means negative hormone receptor and HER2 expression),
then there are no roles for both endocrine therapy and targeted therapy. The
only systemic treatment would be chemo.
Again, for early stage breast cancer, the cure rate is pretty high, even
with local lymph node metastases.
Due to the widely use of neoadjuvant chemo (chemo before surgery), it might
not need mastectomy. Breast-preserved lumpectomy is often adequate. This
could be followed by adjuvant chemo or radiation therapy, depending on your
situation.
Hope the above information helps.
