On treatment issue

Summary:

49/F pT2N1, on External RT to the breast.

On treatment issue

Nikhilesh Patil 18 Aug 2010 23:04

Guys, we have an ontreatment issue.
49/F, pT2N1 Breast Cancer patient.
Large dense breast, on external beam, conventional tangents, in her 3 rd week has swelling and pain in the treated breast. We tried seroma aspiration, antibiotics, anti-inflammatory meds, good support bra etc., nothing helping, NO CLINICAL recurrence, patient still has pain and edematous breast.
We dont want treatment breaks , any suggestions or ideas ?

Nikhilesh

Re: On treatment issue

Dr Nilesh Mahale 19 Aug 2010 05:38

You can try low dose steroids, serratio peptidase (chymoral forte)
If that doesn't work, you can stop her whole breast RT for now, start tumour bed boost and then restart balance whole breast RT

Re: On treatment issue

Santam Chakraborty 19 Aug 2010 12:58

What do the surgery people say? Is there any evidence of infective etiology?

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Re: On treatment issue

Nikhilesh Patil 19 Aug 2010 17:57

Thanks for the input guys,
We do not have Chymoral forte available in North America, its not approved by FDA. Serratopeptase is available in some of the stores over the counter but then there is no evidence for us to prescribe, the literature that comes up is from Dentistry and infact some of the papers are from India. This can be a good clinical trial in RO in patients where we expect edema. I remember using it many situations with questionable benefit.
I personally wanted to try ice-packs however the surgeon has given a nick/incision to drain the collection and obviously RT is stopped. It dosn't look infected though.
Nikhilesh