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Which is the next best treatment step?

Page last modified on: November 20, 2008
Question from SandyW: I had a mastectomy five years ago, did four cycles AC, four cycles Taxol, 35 rads, three years of tamoxifen. This year, the cancer recurred with metastases to lymph nodes, lungs, and liver. I started Aromasin in August, but there has been no change in PET in four months. My oncologist said I could either stay on Aromasin or go to chemo with Taxotere or Abraxane. I don't know how to make this decision myself. Help!
Answer —Generosa Grana, M.D., F.A.C.P.: This is a situation where you need to sit down with your oncologist and have more of a discussion. In metastatic breast cancer, no growth is an acceptable thing. We don't always look for shrinkage and disappearance. We call your situation "clinically stable disease" and this is a very meaningful response. So oftentimes we don't change the chemotherapy but rather continue the hormone therapy until there is progression of disease. But again, your specific case should be discussed with your oncologist.

In women with metastatic disease, our goal is to slow the pace of the disease and if we're lucky to eradicate the disease, but you use your least toxic drug first. In a women who is hormone-positive, most people will use hormonal therapy as long as it works, then consider changing to another hormonal agent and really not rush into giving up on these agents and moving to chemotherapy because of the added toxicity of chemotherapy.

On Wednesday, December 21, 2005, our Ask-the-Expert Online Conference was called Updates from San Antonio Breast Cancer Symposium 2005. Generosa Grana, M.D., F.A.C.P. and moderator Marisa Weiss, M.D. brought you the highlights of the 2005 Breast Cancer Symposium and answered your questions about the latest diagnostic and treatment options for breast cancer.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Generosa Grana, M.D., F.A.C.PGenerosa Grana, M.D., F.A.C.P. is the director of the Cooper Cancer Institute and heads the division of hematology/medical oncology at Cooper University Hospital.

Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.

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