HI, MY mom diagnosed with metestatic triple negative. Receiving first treament today at Mayo Phoenix, We would appreciate any input.
Treatment plan, April 2021
there will be 6, 28 day cycles with weekly chemo. Each visit includes Tezolizumab, and day 8 will also add Abrazane/paciltaxol
74 y.o. female with a history of clinical stage I (cT1ccN0cM0, ER-, PR-, HER2-, grade 3) upper inner left breast cancer, now with metastases to lung and liver.
HISTORY OF PRESENT ILLNESS
She was on clinical trial: RU011501 folate receptor alpha vaccine. She has started to developed some dyspnea on exertion and shortness of breath, in particular in her right lower lobe. Evaluation led to imaging, and identification of a large left lower lobe necrotic lung mass, with regional adenopathy. He was not clear if this was a primary lung cancer or a metastatic lesion. She does have a long history of tobacco use. She was also found to have multiple liver lesions. She underwent biopsy of both, final pathology was consistent with metastatic triple negative breast cancer. PDL1 testing of the liver lesion showed 1% reactivity by immunohistochemistry.
ONCOLOGIC HISTORY
Oncology History Overview Note
She reports in 1997 she developed left breast DCIS which was identified on screening mammography. We do not have the record of receptor status. She received lumpectomy followed by radiation.
The patient otherwise was healthy until 2005 when once again on screening mammography she was found to have a right breast mass. This was biopsy proven to be invasive ductal carcinoma ER negative, PR negative, HER2 negative. The tumor measured 1.3 cm and was grade 2. She was given the clinical stage I. For therapy she received lumpectomy with intraoperative radiation followed by postoperative radiation. She also received Adriamycin, cyclophosphamide and paclitaxel. She had to discontinue paclitaxel early prior to completing therapy secondary to peripheral neuropathy development.
In April of 2019 the patient had missed her screening mammography in 2018. She presented for screening mammography where the noticed an abnormality in her left breast. This is followed by ultrasound which confirmed an approximate 1 cm mass at the 11 o'clock position in her left breast. The patient subsequently received MRI which showed this 7 mm mass in the 11 o'clock position as well as a 4 mm mass in the left breast. The over-read of this MRI at Mayo Clinic confirmed the 7 mm mass in the 11 o'clock position but son no other abnormalities. On 05/06/2019 she underwent ultrasound-guided biopsy which showed invasive ductal carcinoma, grade 3, ER negative, PR negative, HER2 negative. None of the imaging studies showed concern of lymph node involvement. She was given the clinical stage, stage I.
She received neoadjuvant carboplatin and gemcitabine chemotherapy with partial disease response, she did not tolerate paclitaxel. She has had bilateral pulmonary emboli on Xarelto. Genetic testing showed:
Positive Results: Pathogenic PALB2 c.1248del (p.Met416Ilefs*8) variant
Uncertain Results: VUS in POLE c.461G>A (p.Arg154Lys)
She underwent bilateral mastectomy under the care of Dr. Barbara Pockaj on November 15th. She had a residual 12 mm tumor, ypT1c N0, RC B2, 20% cellularity.
Thank you Carmen 602-434-1289 carmengustin@gmail.com