Breast Cancer Recurrence Risk and Treatment Options

Please provide the content you would like me to translate regarding breast cancer?

Thank you for the doctor's response.
I have a low level of education and do not understand what the doctor means by medication treatment.
Hello! Your cancer recurrence index is as high as 136 (with >30 indicating a high recurrence rate).
It is recommended that you undergo chemotherapy and radiation therapy after giving birth.
For chemotherapy, it is suggested to start with European paclitaxel combined with cisplatin; if you have insurance, you can opt for carboplatin out-of-pocket.
After that, you will receive E+C.
Could the doctor please explain this again? So, does my recurrence index indicate that I have the highest risk, and does that mean the prognosis is not good?

Wúzhù de yùnfù, 30~39 year old female. Ask Date: 2016/10/08

Dr. Li Zhonghuai reply Surgery

Hello! Yes, it is recommended that you proceed with the necessary treatment.
Although chemotherapy regimens may vary between hospitals, the principles are generally similar.
From the current medical perspective, breast cancer is considered a systemic chronic disease.
After treatment, it is important to closely follow up with your physician.
You are at stage IIa, so for the first three years, follow-ups should be every three months, then every six months for the next three years, and thereafter annually.
This should continue for at least 10 years.
Stay strong! Wishing you safety and health! Changhua Hospital cares about you!

Reply Date: 2016/10/08

More Info

Understanding breast cancer recurrence risk and treatment options is a critical aspect of managing the disease, especially for patients who have already undergone treatment. In your case, the recurrence index of 136 indicates a high risk of recurrence, which necessitates a comprehensive treatment approach.

Recurrence Risk Assessment
The recurrence risk index you mentioned (>30 being considered high) suggests that your cancer has characteristics that make it more likely to return after initial treatment. Factors influencing recurrence risk include tumor size, grade, hormone receptor status, and lymph node involvement. In your case, the high recurrence index indicates that the cancer may have aggressive features, which is concerning.

Treatment Recommendations
Given your high recurrence risk, the recommended treatment plan includes chemotherapy and possibly radiation therapy after childbirth. The specific chemotherapy regimen suggested involves:
1. European Taxol (Paclitaxel): This is a taxane chemotherapy drug that works by inhibiting cell division, effectively targeting rapidly dividing cancer cells. It is often used in breast cancer treatment due to its efficacy in reducing tumor size and preventing recurrence.

2. Cisplatin: This is a platinum-based chemotherapy drug that is effective against various cancers, including breast cancer. It works by causing DNA damage in cancer cells, leading to cell death.

3. Carboplatin: If you have insurance coverage, this drug may be used as an alternative to Cisplatin. Carboplatin has a similar mechanism of action but may have a different side effect profile, making it a suitable option for some patients.

4. E+C Regimen: This likely refers to a combination of Epirubicin (E) and Cyclophosphamide (C), which is a common chemotherapy regimen for breast cancer. This combination is effective in treating hormone receptor-positive and negative breast cancers.

Prognosis and Follow-Up
Your concern about the prognosis is understandable, especially with a high recurrence risk. While a high recurrence index indicates a more challenging prognosis, it does not mean that effective treatment options are unavailable. The goal of the recommended chemotherapy is to reduce the risk of recurrence significantly and improve overall survival rates.

Regular follow-up appointments and imaging studies will be crucial in monitoring your response to treatment and detecting any signs of recurrence early. It is essential to maintain open communication with your healthcare team, as they can provide personalized advice based on your treatment response and any side effects you may experience.

Conclusion
In summary, your high recurrence risk necessitates a proactive approach to treatment, including chemotherapy with agents like Paclitaxel and Cisplatin, followed by the E+C regimen. While the prognosis may seem daunting, advancements in breast cancer treatment have improved outcomes significantly. It is vital to adhere to the treatment plan and attend regular follow-ups to monitor your health closely. If you have further questions or concerns, do not hesitate to reach out to your healthcare provider for clarification and support.

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