FM AUGUST 2018 ISSUE1 - digital edition
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case reports<br />
Treatment resistant metastasis<br />
How genetic screening altered the<br />
course of treatment in an aggressive<br />
form of breast cancer<br />
R<br />
ecent trends indicate that early onset of breast cancer<br />
is becoming more prevalent, with about 5-10% being<br />
inherited. While treatment options have considerably<br />
increased over the past few years, it is becoming clear that they<br />
may not work for all types of breast cancers. Recently, genetic<br />
testing to identify gene mutations associated with breast cancer<br />
is gaining prominence, mainly because of its role in early<br />
identification of individuals at risk, and for choosing optimal<br />
therapeutic option and even predicting the prognosis. While<br />
genetic testing can play a lead role for individualization of<br />
treatment in patients already diagnosed with cancer, a surprisingly<br />
less-talked about, but important scenario is the addressal of<br />
anxiety and uncertainty in relatives of cancer patients who<br />
consider themselves at risk of developing the disease. Discussed<br />
here is a case where genetic testing not only proved to be an<br />
important tool to facilitate effective treatment, but also where the<br />
family was made aware of the potential cancer threats that may<br />
await them in the future.<br />
Smita (name changed), a 55-year old female, was diagnosed with<br />
breast cancer (ER-ve/PR- ve/Her2+ve) that had metastasized to<br />
the lung, liver and the brain. The patient was put on Herceptin<br />
treatment, but the progression of the disease did not seem to<br />
68 / FUTURE MEDICINE / <strong>AUGUST</strong> <strong>2018</strong>