Aftercare past breast cancer surgery

The breast cancer has been removed, the therapies are provided.

Now it is very important that in regular intervals the breast is examined in order to recognize immediately the appearance of possible new cancer cells.

For the aftercare I have chosen the breast center, as I already knew the physician. He wanted to see me for detailed examination three months after the end of the radiotherapy. I did not fear that something bad could have developed, as I knew that the cancer had been thoroughly removed, going far into healthy tissue. And the well planned radiotherapy has surely destroyed any remaining cancer cells...

The results three months after the radiotherapy (6 ½ months after the surgery):

Ultrasound pictures:

scar tissue structure

Mammograms

three PICTURES

Mammography findings:

two PICTURES

Aftercare appointment of August 16^th, 2004:

Benign findings,that means, that the mammography did not show a suspicion for malignant changes.

I am considered since several years as a risk patient for osteoporosis. A bone density measurement in August of 2004 was supposed to show if taking "Arimidex" since May 16th, 2004, could be justified, because an aromatase inhibitor contributes to a faster bone loss. The DXA measurement revealed a bone density inside the norm. However, in more recent X-ray pictures, a progressive degenerative modification was visible.

Aftercare appointment of December 6^th, 2004:

The examination of breast and axilla did not show anything uncommon in the ultrasonic investigation.

Aftercare appointment of April 11^th, 2005:

According to the ultrasonic investigation of the breast, everything is okay.

The ribs hurt a little under pressure. Could it be an after-effect of the radiotherapy?

I would like to discontinue the aromatase inhibitor "Arimidex" after exactly one year because of the following side effects:

- As I have been classified in 1987 as osteoporosis-prone, I have taken for more than 16 years "Kliogest" (hormone substitution) which I had to drop after the appearance of the breast cancer. Therefore, the osseous decrease is presently no longer restrained. Furthermore, an aromatase inhibitor even increases the risk. My big worry is that the bones could become friable and thereby both hip prostheses would become loose.

- Since many years I suffer at times from a very fast pulse. A beta blocker helps when it suddenly appears. - However, during the past months the beta blocker has no longer been very efficient. I had some attacks lasting many hours with very high pulse (about 180) and extremely low blood pressure (mostly under 85/50). I came more and more to the conclusion that the medicine "Arimidex" could be responsible for the indispositions, which are linked with states of anxiety. (Remark: please notice the entry under April 12^th, 2006.)

- Instead of increasing my weight again with big food servings and extremely many sweets, I have further lost weight. With 43 kg remaining, I seem to exist only as a surplus of skin and bones with some muscles inbetween.

However, I do not know whether "Arimidex" can be held responsible for this. I just mention it, since taking that medicine, I have constantly lost weight. Nevertheless, I have generally felt very well!

Since May 16^th, 2005, I take no longer the aromatase inhibitor

with the agreement of my aftercare physician. In spite of this, eventually still remaining cancer cells will probably have no chance to grow again as they surely will be discovered at an early stage. I know myself in good care.

Now, four weeks later, I am already gaining weight again! The fast pulse attacks that were often appearing during the past months, have not shown up anymore since.

Aftercare appointment of December 21^st, 2005:
The ultrasonic investigation of breast and shoulder lymph nodes did not show anything unusual.

The international guidelines say that twice a year a thorough investigation of the breast and once a year a mammography should be sufficient as an aftercare. Only in case of additional discomfort (pain) would further investigations have to be done.

Because of the discontinued aromatase inhibitor, yet another third investigation became important for me in this second year.

Since last summer I felt increased pain in the spinal column. I gradually became uncertain, if maybe metastases were spreading. An additional examination would bring here a clarification.

January 16^th, 2006: skeleton scintigraphy

The new photographs agreed quite well with those of February 2^nd, 2004 (see picture in "Surgery"). In the spinal column, lumbar vertebrae 2/3, a black spot is to be seen in comparison with 2004. This was however already faintly visible at the earlier time. In conclusion, no definite reference to skeletal metastases.

One week later:

the skeleton scintigraphy has been compared with a DXA bone density scan of August 2004 and two conventional x-rays of the spinal column of Sept. 2004. These x-rays already at that time clearly showed degenerative changes in the vertebral column at the same place where today's intensifications appear.
Thus, as overall conclusion:

no reference to metastases in the bones.

(it is always good to have former pictures ready for comparisons)

Aftercare appointment of September 1^st, 2006 - Results one year after the last mammograms:

Mammograms of Septemer 2006		Mammograms of August 2005
	There is a difference between the former pictures and those of this year: the current ones are digital.
two PICTURES
The mammography and the ultrasonic investigation of the breast and axillary lymph nodes did not show a suspicion for malignant changes. Detailed mammography findings:

Scar zone left breast	Scar zone right breast	Axilla lymph nodes	MG (two PICTURES)

Aftercare appointment of August 22^nd, 2005 - Results one year after the last mammograms:

Ultrasound pictures: scar tissue structure	Ultrasound picture: lymph nodes	Mammograms

two PICTURES	one PICTURE	two PICTURES

The mammography did not show a suspicion for malignant changes. Detailed mammography findings:
Aftercare appointment of December 21^st, 2005: The ultrasonic investigation of breast and shoulder lymph nodes did not show anything unusual. The international guidelines say that twice a year a thorough investigation of the breast and once a year a mammography should be sufficient as an aftercare. Only in case of additional discomfort (pain) would further investigations have to be done. Because of the discontinued aromatase inhibitor, yet another third investigation became important for me in this second year.
Since last summer I felt increased pain in the spinal column. I gradually became uncertain, if maybe metastases were spreading. An additional examination would bring here a clarification. January 16^th, 2006: skeleton scintigraphy The new photographs agreed quite well with those of February 2^nd, 2004 (see picture in "Surgery"). In the spinal column, lumbar vertebrae 2/3, a black spot is to be seen in comparison with 2004. This was however already faintly visible at the earlier time. In conclusion, no definite reference to skeletal metastases.