Stage IV HR-Positive Breast Cancer: Alison's Survivor Story

This breast cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Biomarkers
ER-positive; PR-positive; HER2-positive
Sex
Female
Spread to
Cervical/neck lymph nodes
Treatment
chemotherapy, targeted therapy, surgery, radiation and hormone therapy
Outcome
Living With Cancer / Remission

Treatment course, step by step

  1. Initial treatment: 6 cycles of TCHP (Taxotere, carboplatin, Herceptin and Perjeta) → bilateral mastectomy with right axillary lymph-node removal → radiation → Lupron plus anastrozole (Arimidex) and completion of 6 months of Herceptin.
  2. First neck-node recurrence: gemcitabine, fractionated cisplatin, 5-FU and leucovorin [60% reduction after 1 round; complete remission after additional rounds].
  3. Second neck-node recurrence: Adriamycin, cyclophosphamide and Abraxane with Herceptin, followed by radiation; doxorubicin was replaced by capecitabine during radiation.
  4. Maintenance later changed from Adriamycin to Navelbine after the lifetime dose was reached.

What happened, in summary

Alison was 34 and breastfeeding when she found a lump under her right arm. Biopsies confirmed triple-positive breast cancer in the breast and axillary lymph nodes. After HER2 testing returned equivocal 3 times, the final result guided a TCHP regimen: Taxotere, carboplatin, Herceptin and Perjeta every 3 weeks for 6 cycles. MRI showed a major response.

She then underwent a bilateral mastectomy with right axillary lymph-node removal, followed by radiation, ovarian suppression with Lupron, anastrozole and completion of 6 months of trastuzumab.

Soon afterward, Alison felt a new neck lymph node. Biopsy confirmed recurrent breast cancer and stage 4 disease. A second-opinion regimen combined gemcitabine, fractionated cisplatin, 5-FU and leucovorin. Imaging after 1 round showed a 60% reduction, and additional treatment produced complete remission. A second neck-node recurrence required another change: Adriamycin, cyclophosphamide and Abraxane with Herceptin, followed by consolidation radiation. During radiation, capecitabine replaced Adriamycin.

Once remission was restored, Alison continued maintenance chemotherapy on alternating treatment and rest months. After reaching the lifetime Adriamycin limit, she changed to Navelbine. At the latest update, she had remained in complete remission since August 2017 while receiving 1 month of chemotherapy followed by 2 months off. She focused on parenting, counseling and taking the experience one day at a time.

Where this story comes from

This is a lay summary of an account first published by The Patient Story. Read the original in full

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