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Chemotherapy for breast cancer?

Q: I was diagnosed with breast cancer 2.5 years back, which had also metastasised in vertebra and also in hip bone. My cancer was ER/PR Positive. I was given chemotherapy (adriamycin, cyclophosphamide two cycles and then adriamycin and taxol 6 cycles). I had also started taking tamoxifen since then. Chemotherapy was completed one year ago. After that my mammography was normal. But bone scan showed multiple metastsis in my vertebra and hip bone also. I was also given 12 cycles of 90 mg aredia. But my mammography was normal. Till 8 months ago, I was pulling along with off and on pain in my back and also some times in shoulder. From this period I have also noticed that my right nipple is now drawn inside. My right breast had become hard in comparison to left one after treatment, though the mammography was normal. After this, cord compression in my vertebra was diagnosed on MRI. Tamoxifen was stopped and radiation of spine was done. After this I was prescribed Mestrel 160 mg daily. Since four months, I am having severe pain in my hip bone. Three months ago, mammography showed again tumour activity. From last month, I am taking Chemotherapy (taxotere). I have completed two courses (each of three cycles weekly 60 mg each). I am continuing with mestrel 160 mg daily. Last week, my right ovary was removed. Left ovary was already removed nine years ago. Presently there is swelling in my right arm, my axilla is normal and my veins are normal as shown by Doppler Sonography. The swelling in my right arm started when I took third dose of docetaxel in my right hand. Pain in hip bone is now not there. Should I continue with Mestrel? After removal of ovary which will be better medicine for me - Mestrel or Femera? Please suggest me any other treatment (chemotherapy / oral drug).

A:You are responding to the chemo protocol since there is no pain. Your right arm swelling may be due to the disease or due to chemo. We need to examine before we can be sure. After removal of ovaries - aromasin or femara can be used when there is failure to mestrel. Other chemo drugs include xeloda (oral), and vinelbine and gemcitabine (intravenous).

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