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Initially diagnosed June 4, 2009 Invasive Ductal Carcinoma Stage II,Grade II tumor size: 2-3 cm node positive ER/PR postive HER2 Neu - negative Current Diagnosis: Metastatic Invasive Ductal Carcinoma Grade 3 Mets: Scalp/skin, Liver, Spine, Bone ER/PR + HER2/NEU -

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Thursday, April 24, 2014

Results from Baseline Scans Done on 4/13

Well, the results from the new set of baseline ct scans I mentioned in a previous post have finally showed up on the my.MDAnderson.org website.  The scans were done to establish a new baseline set of scans to compare to another set I will do in June. The goal is to show that my disease is stable, rather than progressing, so I can qualify for the immunotherapy vaccine trial that I was previously disqualified from.

I expected the baseline to be about the same as the one that was done less than a couple of months prior to this one on 2/22;however, it appears that things have changed a little more than expected in that one month time frame.  Now, before I give you the results, I want to add that this may be due to the fact that I had to be taken of my oral chemotherapy for 6 weeks before I could even be considered for the trial and that had preceded the scans on 2/22.  On 2/22 they did give me my first Lupron shot and I have had 2 addtional shots 28 days apart over March and now April.  I also did not start the aromatose inhibitors until 28 days after the shot on 2/22.  So for a large amount of the period between the scan on 2/22 and the on on 4/13 I was basically only being pushed into post menopausal status and was not receiving any additional treatment that would prevent cancer growth until I started the Femera on 3/24.

So having given a possible cause for the difference in results, I give you the results of my blood tests and ct scans done on 4/13 at MD Anderson:

There appears to be, again some progression and some regression.  Mixed results again, pretty much the same type of mixed results we were seeing on the previous comparison between the October scan and the 2/22 scan. In addition to these results, my CA 15-3 tumor marker increased from 61 on 3/28 to 75 on 4/13.  Rising tumor marker numbers tends to indicate the progression of the tumors.  Anyhow,  here is the actual medical mumbo jumbo I just summarized and interpreted for you:

Examination: CT Chest with IV contrast

Stable postradiation changes are in the right apex and left lung base. There is no suspicious lung nodule or pleural effusion. 
Stable mildly prominent nodes, such as in the AP window, paratracheal, and bilateral parahilar spaces are stable. For example, an AP window 10 x 15 mm node (series 3 image 47) is unchanged. 
Widespread mixed lytic and sclerotic osseous metastases are again noted. A lower thoracic spine sclerotic 6 mm metastasis has slightly increased since prior measurement of 3 mm (series 3 image 81).

1. Sclerotic and lytic osseous metastases, with some marginally increased since 02/21/2014. No appreciable progression. 
2. Stable nonspecific mildly prominent mediastinal and perihilar nodes. 

Examination: CT Abdomen and Pelvis with IV contrast

Bilobar liver metastases are again noted. Some have marginally decreased since 02/21/2014. For example a hepatic dome punctate lesion (series 3 image 147) previously measured 3 mm. A segment IV 5 mm metastasis (series 3 image 153) previously measured 8 mm. A left hepatic 4 mm lesion (series 3 image 162) previously measured 6 mm. There is no intrahepatic ductal dilation. 
Gallbladder, spleen, pancreas, adrenal glands, kidneys are within normal limits. 
There are no abnormally dilated loops of bowel or ascites. 
No progressive adenopathy in the abdomen and pelvis is seen. Treated/residual small volume periportal and periaortic nodes are unchanged since 02/21/2014. 
Uterus has a heterogeneous echotexture. A lobulated mass in the left adnexa (series 3 image 279) could be related to a left ovarian metastasis versus a pedunculated fibroid, and is unchanged since 10/08/2013. 
Multiple mixed lytic lytic and sclerotic osseous metastases are overall not significantly changed. 
1. Slight improvement in bilobar liver metastases. 
2. Grossly stable sclerotic and mixed osseous metastases. On same-day CT chest, one of the sclerotic osseous metastases is new, which may represent progressive disease versus an element of treatment response. 
3. Stable left adnexal heterogeneous mass, possibly related to an exophytic fibroid or an ovarian metastasis, unchanged since October 2013. 

They will be doing the next scan in June to compare back to this one to see if progression has continued while on the Lupron and Femara.  If it has not progressed from the baseline scan, I will qualify for the vaccine trial, if not, I will be disqualified again and it will show the Femara is not working and they will probably look for another trial or another standard therapy to move me to.


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