Patient: right second rib pain, breast cancer detected in winter 05, left mastectomy and chemotherapy. In October of this year, I had a rib pain, and the examination said that bone metastasis was considered, and I had surgery to remove it, and then chemotherapy, and now I asked to go to radiotherapy (chemotherapy has not yet finished). I would like to ask if the various methods mentioned in the article “Expert Consensus on Clinical Management of Bone Metastases in Breast Cancer (2007 Edition) – Reprinted from CSCO website are independent of each other? For example, is it true that radiotherapy is not necessary after surgical treatment? Also, should patients have regular checkups in the future, and if so, can you make some suggestions on what tests to do? Gu Yuanting, Department of Breast Surgery, First Affiliated Hospital of Zhengzhou University
Yuanting Gu, Department of Breast Surgery, First Affiliated Hospital of Zhengzhou University.
One. First of all, trust and cooperate with the treatment plan provided by your supervising physician, because he knows your medical history best.
ii. My own views.
1. The systemic treatment of bone metastases is based on endocrine therapy. If hormone receptor negative or bone metastases appear during endocrine therapy, chemotherapy should be considered. If the hormone receptor is positive, chemotherapy should be continued after endocrine therapy. That is, the two means of systemic treatment are not conflicting.
2. The local treatment of bone metastasis is mainly radiotherapy. It is mainly for the ribs and other parts of the body where pathological fractures are less likely to occur or have little effect on the body after fracture. However, for weight-bearing bones, such as vertebrae with increased likelihood of compression fracture, or long bones with potential pathological fracture, etc., you may consider requesting orthopedic treatment. In response to some of the information you provided, I think that if the isolated metastases in the ribs have been removed, no radiotherapy can be considered.
3. Regular review is needed. In addition to routine liver and lung review, bone scan is indispensable.