45F Metastatic Rt Breast cancer with brain and bone Mets @KHL

45F Handloom worker by occupation presented  with biopsy proven Rt Breast adenocarcinoma came for treatment

She was apparently normal till Aug 2019 then she noticed a small swelling in the axilla which was peanut in size which was painless and she ignored it later.

1-2 months later she noticed a similar small swelling in her Rt Breast which was peanut size initially and progressed in size. 

In Feb 2020 she had USG Rt Breast and diagnosed with Fibrocystic lesion in Rt brest ( Hypo to Anechoic lesions with No vascularity) and suggested FNAC of swelling.(which was not told to attenders by attending physician outside) 

In August 2020 Patient developed severe low back ache, Difficulty in walking, weight loss, Generalized weakness, headache, neckpains and increase in size of lesion then she consulted an oncologist and FNAC was done showing malignant cells and core needle biopsy showing Invasive Ductal carcinoma

Molecular status : ER+ PR+ Her2neu + ( triple positive Breast cancer)

PET CT findings are consistent with Bone and brain Mets 

Then patient was given Palliative Radiotherapy for whole brain, C7, sacrum and Pelvis in November for 10 continue days. Where she developed side effects of radiotherapy like discoloration of skin, mucositis, generalised weakness and She was started on inj. GCSF for Bone marrow depression (pancytopenia).

No blood transfusions were done.

Then she was started on Chemotherapy  with 

Inj. 5FU 500mg

Inj. Adriamycin 50mg

Inj. Cyclophosphamide 500mg

And bisphosphonate therapy With inj. Zolendronic acid 4mg.

She received 6 cycles of chemotherapy with 24 days interval between each cycle.

After last cycle she developed Generalized pruritic body rashes and hairfall.

After completion of 6 cycles of chemotherapy she was started on tab. Tamoxifen 20mg OD daily with inj. Zolendronic acid monthly once.

Latest USG abdomen - Normal

Chest xray - Normal

SUMMARY : 

45F with Metastatic triple positive invasive Ductal adenocarcinoma of breast(Rt) with Brain and Bone Mets who recieved palliative Radiotherapy and 6 cycles of chemotherapy And Bisphosphonate therapy.

Inj. 5FU 500mg

Inj. Adriamycin 50mg

Inj. Cyclophosphamide 500mg

And bisphosphonate therapy With inj. Zolendronic acid 4mg.

She received 6 cycles of chemotherapy with 24 days interval between each cycle

Response to treatment: 

Size of Breast lump decreased

Low back ache relieved ( previously she used to come in streture/ wheel chair now she is coming by walk)

Headache, neck pain subsided.

Willing to do her regular work.