My Mets Breast Cancer Story: Questions about Low WBC, spots on liver

Thank you for the information. As a RN and having been clinically involved for many years, it is imperative that patients have confidence in their doctors and their recommended treatment modalities. There are many factors involved in deciding a specific treatment plan for any patient who presents with a medical issue. There is no such thing in cancer treatment as one size fits all. My team consists of pathologists, rad onc, medical onc, ortho onc, and my IM. They all discussed my findings. The consensus was to radiate with AI treatment with close follow up. I have the upmost confidence in my team and their treatment plan for me.

@maliamd, I moved your 2 discussions into one so that members can follow your story and have all the details. I'm glad that you have confidence in your team. You're quite right that many factors go into creating an individualized treatment plan.

About HER2 positive breast cancer, I found this excerpt from an article from Mayo Clinic (https://www.mayoclinic.org/breast-cancer/expert-answers/faq-20058066)
"Treatments that specifically target HER2 are very effective. These treatments are so effective that the prognosis for HER2-positive breast cancer is actually quite good.
...
Whenever breast cancer recurs or spreads, the cancer cells should be retested for HER2 as well as for hormone receptor status, as these can change from the original diagnosis."

Maliamd, was the HER2 status of your diagnosis detected at the initial diagnosis of IDC 4 years ago or only with the detection of recent metastasis? Have anti-HER2 drugs been discussed as a treatment option? I look forward to hearing what you learn after this week's round of imaging.

I re read by biopsies. Original tissue sample 4 years ago showed invasive ductal carcinoma was ER+ and PR+. Ran tests for HER2...the tests were clean. Recent tissue biopsy on current spread showed ER+. No progesterone. Tested for HER2 and was clear once again.

Sorry for my miscommunication.

Thank you for checking. The treatment protocol aligns with HER-negative. I think @californiazebra @glendafl @orsejr and @cjs123172 will appreciate the pathology correction. It seems like your diagnosis is more similar to that of @eku,

@maliamd, will you be meeting with your team soon to discuss next steps?

I met with my rad onc today to discuss the Pet Scan. Will meet with med onc tomorrow to discuss treatment going forward, I have only been on treatments for 3 months and all ready see improvements in my bones.

So you never were HER2 positive , correct? I am wishing you nothing but the best. Happy Thanksgiving !

Never HER2 positive.

@maliamd
In regard to your low WBC. Mine is low from Kisqali which is like Ibrance. I do my monthly test on my off week and WBC ranges from 2.5-3.5. I’m sure it’s even lower during the 3 weeks I’m taking the meds. I’ve been taking the meds for 2 yrs 9 mo. and have had good luck going to movies, concerts, restaurants, birthday parties, etc. I don’t go if I know someone is sick. If I hear someone coughing I’ll put on a mask. I wore a mask on recent plane flights. Luckily that’s easier to do in the post pandemic world. No one has said anything to me, but if they do I’ll just tell them I have cancer and that will stop them. Anyway, I’ve had good luck being out and about. I am a big hand washer and use hand sanitizer a lot. I’ve always been extra cautious during flu season even before cancer because when I get sick I get really sick — my whole life. Best wishes. 🙂

@maliamd
One other note. My oncologist said my neutrophil count has to remain above 1.0 to continue treatment so obviously that count is a big concern to him. You might want to watch your score on that.

To be clear, in my previous message I’m not saying throw caution to the wind. Just that I’ve been pleasantly surprised that I haven’t been getting sick with my compromised immune system. I have only been really sick once since taking Kisqali. Caution is good. I am selective about where I go, but I don’t stay isolated.

With movie theaters, I go to the first matinee showing and it’s usually pretty empty.

If I hear someone sneezing in a store that’s the end of my shopping trip there.

@maliamd
You sound like you are in great shape overall, I believe that will definitely help you.
I'm on Verzenio + anastrozole. My WBC is generally low as well. My onco does not seem to be worried about it. I am usually OK attending outside activities without a mask. I wear one to shopping malls, supermarkets, flights, etc. Funny -kind of- story about WBC: I cut off the tip of my finger on Friday (kitchen accident). Went to ER and it took several hours to stop the bleeding. They did a blood test and my WBC was the highest since my diagnosis 🙂 🙂 🙂 (turns out an injury does that to you)
RBC dipped on the other hand.