Q: My mother aged 60 years has been diagnosed with breast cancer on the left side T4 N1 M0 i.e stage III B. She is being administered chemotherapy as neo-adjuvant therapy. In the first 4 cycles of chemotherapy, she was administered adriamycin, cyclophosmamide. Meanwhile, for the last two months she is also suffering from swelling in the left arm. The swelling has not come down and is unchanged. The tumour in the breast has responded well to the treatment and has reduced drastically while the swelling in the left arm has not come down. The doctor has administered 5th cycle of chemotherapy with epirubicin and cyclophosphamide. He informed me a 30% chance of survival in the next 2 years. Kindly tell me whether the lymph node disease is a life threatening one and what is the next course of treatment that will follow?

A:The treatment for breast cancer at this stage will be to down stage the size of tumor with chemotherapy, so that it can be removed surgically (total radical mastectomy) and then followed by local radiation. These patients are usually given 6-8 cycles of chemotherapy, one sequence that is commonly followed is: 3-4 cycles then surgery/RT and then 3-4 cycles. Patients with lymph node involvement can still be cured of their cancer. Swelling in the arm is possibly due to lymph node involvement in the axilla.