Several students could understand the reason for Teacher Du's hesitation just by looking at the patient's medical records.
"The pathology of her tumor shows that it belongs to Luminal type B." Du Haiwei read the pathology report results written in the medical record.
The family member accompanying the patient should be the patient's mother, and responded: "Yes, yes, the doctor over there got the report after the operation and told us that this classification is good and the treatment effect will be better. No.
Do you know why my index can’t come down after taking medicine?”
"One-third of patients will develop resistance to these drugs, which means that they usually do not produce the therapeutic effect that the doctor wants to achieve after taking them." Du Haiwei said, "Her pathology report showed that the tumor in her body was
It is estrogen-dependent. If these drugs are effective, they can interfere with estrogen receptors. But now it seems that they are ineffective."
The two students sitting across from him discovered that Teacher Du was not a talkative, he could definitely say what needed to be said, and he was very patient with the patients' families.
The family member said: "We heard these words from the breast surgeon, saying that we need to come to your gynecology department for surgery."
"She is too young and has lymph node metastasis. Has the breast surgeon discussed these issues with you?" Du Haiwei continued to ask in a steady voice.
Judging a cancer patient's condition, including prognosis, requires a comprehensive analysis of all data. Just looking at the pathological classification is not enough. It must be combined with factors such as stage and patient age to make a judgment.
This patient's so-called better-classified Luminal type B is a very subtle situation. The test results showed that the estrogen receptor ER progesterone receptor PR was positive and the human epidermal growth factor receptor HER2 was negative. These indicators indicate the use of endocrine therapy.
This patient's tumor cells may have a targeted effect. For breast cancer patients, endocrine therapy can be said to be the most life-saving method. For example, the three yins that are most frightened by doctors and patients in clinical practice cannot be treated with endocrine therapy.
These patients have the lowest survival rate.
Luminal type B compared to the best Luminal type A, the worst thing is that another indicator Ki-67 is not very good. High Ki-67 means that the tumor cell proliferation status is high and the tumor cell proliferation in the body is too active. So in this
In the staging of the patient, we can see the results shown by Ki-67: During the tumor resection, it was found that the tumor was large in size and had lymph node metastasis. The staging was 100% poor, and a radical resection was performed. It was definitely impossible to perform a surgical resection.
Clean all cancer cells in the patient's body. The patient is too young, has a fast metabolism, and the possibility of tumor cell recurrence is too high. Taken together, based on the doctor's clinical experience, the patient's prognosis is not ideal.
"I heard the doctor over there mentioned it." The family member's head dropped, and his voice was full of sadness.
"After the operation, the tumor may continue to recur. If this is the case, are you sure you want her to undergo another operation?" Du Haiwei asked.
Sometimes the cruelest thing about being a doctor is that you have to explain the consequences clearly to patients and their families again and again.
The patient's mother wiped the tears from the corners of her eyes with her hands and said the heaviest words: "Doctor, she is only in her early twenties."
Doctors know best about the topic of young people getting sick. I don’t know how many of them I meet every day. Refer to the previous classmates of Pan. People like Teacher Du are really numb after seeing too much.
