Stage IV PIK3CA Breast Cancer: Abigail's Patient Story

This breast cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Biomarkers
Hormone-positive breast cancer with PIK3CA mutation and germline ATM mutation; later PD-L1 somatic change reported. HER2 not stated.
Sex
Female
Spread to
Bone, including femurs, spine, and humeri; later liver
Treatment
surgery, chemotherapy, targeted therapy, hormone therapy, a clinical trial and genomic testing
Outcome
Living With Cancer

Treatment course, step by step

  1. Lumpectomy with 4 lymph nodes removed
  2. planned Adriamycin/Cytoxan for 4 rounds, then Taxol for 12 rounds and radiation; after the first chemo session, tumor-marker blood work led to bone scan/CT and Stage IV diagnosis
  3. titanium rods placed in both femurs
  4. finished Adriamycin/Cytoxan and saved Taxol for later; hysterectomy/oophorectomy addressed ovarian estrogen source
  5. Ibrance + letrozole for 2 years
  6. Piqray after PIK3CA mutation/progression in bone
  7. later Piqray + Faslodex + Kisqali for 2.5 years
  8. genomic/liquid-biopsy research participation and ongoing treatment planning after liver spread and acquired PD-L1 finding.

What happened, in summary

Abigail was 38, running a law firm, raising 2 young children, and breastfeeding when she felt a lump in her left breast in January 2017. She first thought it was a clogged duct. In April 2017, she was diagnosed with strongly hormone-positive breast cancer and initially staged as Stage IIA after lumpectomy with 4 lymph nodes removed. The plan was 4 rounds of Adriamycin/Cytoxan, followed by 12 rounds of Taxol and radiation. After her first chemo session, unexpected tumor-marker blood work led to a bone scan and CT scan. On June 22, 2017, she was told the cancer was Stage IV. A 5 cm tumor was in her right femur, and she later described cancer throughout her bones, including her spine, humeri, and femurs. She had titanium rods placed in both femurs, finished Adriamycin/Cytoxan, saved Taxol for later, and had surgery to remove ovarian estrogen sources. After chemotherapy, she received Ibrance and letrozole for 2 years. When the cancer mutated in 2019, she switched to Piqray for a PIK3CA mutation. Later, Piqray was combined with Faslodex and Kisqali for 2.5 years. As of October 2022, Abigail was living with metastatic breast cancer, later liver involvement, ongoing genomic testing, and advocacy for clinical trials.

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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