Dr Ma, I have invasive carcinoma stage 1c, 11mm lump, HR+ and PR+, HER2-. Removed lump with lumpectomy with clear margins. My oncologists suggested radiation for 5 times plus 4 boosts due to small posterior margin of 0.3mm. Oncotype DX score 21. No chemo needed. Suggested goserelin injections and letrozole for 5 years. I am 50 and premenopausal. I wonder why I'm not given tamoxifen alone, but ovarian suppression injection plus AI? Is this better? What is your opinion? The lumpectomy was done in end of Nov. I expect to have radiation around mid February. My oncologist said I can start the injection right away, but I'm worried about the side effects are making me too sick for the radiation. Do you think delaying the injection after the radiation (about a month delay to early March instead of now) makes a big difference? Thank you.
@BreastHK
6 ай бұрын
What is the lymph node status ? Tumor grade? Ki67?
As you are already approaching menopause, Tamoxifen alone is good enough. You can consider switching to AI after menopause.
@moopraise
6 ай бұрын
@@BreastHK Thank you.
@chuiliu8074
3 жыл бұрын
Dr Ma, I have stage 1 breast cancer ER+ and have been advised to take Tamoxifen for 5 years. I wonder if I should ask about low dose 5mg/daily as there were some medicinal journals suggested low dosage Treatment is as effective as standard dosage.
@BreastHK
3 жыл бұрын
The standard dosage is 20mg daily. I have not come across any practice changing study that suggest 5mg daily. Could you quote the study so that I can have a look first?
@@BreastHK Thank you so much for your prompt reply.
@pshanny5448
2 жыл бұрын
Hello Dr Ma, what kind of treatment would you recommend for chemoprevention for LCIS ?
@BreastHK
2 жыл бұрын
Some old studies advocate Tamoxifen. However, LCIS is considered as benign entity in the latest AJCC classification (8th edition), therefore no chemoprevention is needed.
@pshanny5448
2 жыл бұрын
@@BreastHK Thank you Dr Ma! What would you recommend for patients that have ductal adenoma findings via core needle biopsy, and incidental findings of LCIS via excisional biopsy then?What kind of monitoring/treatment would be appropriate? Thanks so much🙏🏼
@BreastHK
2 жыл бұрын
Annual mammogram and ultrasound will be good enough.
@pshanny5448
2 жыл бұрын
Dr Ma, you have a heart of gold, a generous heart. Thank you for taking the time to answer my questions🙏🏼
Hello Dr. Ma, thank you very much for your detailed information! I had my lumpectomy in Jan and mastectomy in March both in 2017 (that was a zero status cancer, no chemo no radiotherapy). I have been taking tamoxifen since then (3.5 years) for now, period stopped for 1.5 years. My oncology suggested changing tamoxifen to letrozole 2 days ago (now pending my blood result for menopause). I am kind of worrying about the sign effects from the new med (!) I still have hot flash and mood changing, hair thinning etc etc. I do not want joint pain and bone density lost any further! Can I stick with tamoxifen if its with less sign effect? What would you suggest? From your video, sounds like I need to take the medicine at least 6.5 years further. Your comments would be highly appreciated. Thank you so much! Sorry, please reply in Chinese... :).
@BreastHK
3 жыл бұрын
如果覆述正確,零期原位癌其實可以唔食藥,隨時停都得,唔需要轉藥。
@Stellabutterfly2326
3 жыл бұрын
@@BreastHK Thank you so much for your great answer! I can't wait to quit any medicine! Yes, my cancer type was a DCIS (on one side) in 2017. So would your answer be different as I had surgery on one side only? Thanks once again!
@BreastHK
3 жыл бұрын
@@Stellabutterfly2326 冇分別,唔需要食藥。
@Stellabutterfly2326
3 жыл бұрын
@@BreastHK Thank you Dr. Ma. Happy New Year to you all!
@heysarah77
2 жыл бұрын
馬醫生你好,請教一下。我今年40歲,抽針結果係浸潤性癌(ER 90% PR90% HER2 1+, KI 67 5%+)。開刀做了局部切除,腫瘤大小7x4毫米,術後報告顯示為導管原位癌(ER 90% PR 90% HER2 2+, KI 67 約4%+) 。請問這個情況要吃藥嗎,如果要,係電療之後才吃藥還是同時進行? 感謝。
@heysarah77
2 жыл бұрын
補充一個,我淋巴無轉移,謝謝醫生的時間^ ^
@BreastHK
2 жыл бұрын
最好複檢第一次抽針報告,究竟係咪真係浸潤性癌,如果係就食藥。同電療同時進行。
@heysarah77
2 жыл бұрын
Breast HK 愛.乳.希望 當時醫生解釋話,腫瘤比較細,浸潤部分抽針抽左,手術的時候切的部分就是原位。請問一個腫瘤會具有兩種型態嗎?謝謝你。
馬醫生你好!46歲確診 multifocal micro invasive cancer with high grade DCIS, (stage1,無淋巴轉移), ER陰性,PR陽性5%,HER2陽性,左乳切除,無化療,請問我嘅情況PR陽性5%食tamoxifen系否有必要?如果冇食tamoxifen系否會增加復發風險?HER2陽性系否需要治療?希望你畀予一些建議,非常感謝!
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