Expert: Claes-Gustaf Nordquist, M.D. - 8/24/2007

Question
Hi,
My name is Angela I am 26 I hope you can help me with my question. My mother is 64 this year had a double mastectomy almost a year ago now and she is very concerned about secondaries. When her breasts were removed she also had 21 lymph glands removed from under her left arm and a few from under her right arm 4 of the glands were affected by the cancer . As far as Im aware it was a lobular cancer to do with estrogen production. she refused chemo but undertook radiotherapy. She was also put on to Arimedex rather than Tomoxophen (I apologize I am not to sure of my spelling). She is now experiencing constant niggling pain down her left side and a constant burning in the vaginal area, It is not a urine infection according to tests done by our GP. She is very concerned and I would like to settle her mind or confirm her worries either way I feel it would help her to know. She is also due a CT scan of the abdomen and pelvis on Thurs she has been advised not to take her Metformin for her diabetes 48 hrs before and after the procedure, can you tell me if there is any risk in this? I would appreciate it it very much if you could give your opinion on the symptoms I have described above. Also our GP thought it may be adhesions round her bowel fro a cescaeerien 26 yrs ago she is not so sure could you please help. Another additional piece of info is that my mother has lost 2 ribs in the past to eusinaphyllic granuloma and she is also concerned that this is back.


Sorry foe such a long winded an more than likely badly composed letter but I do hope you can help.

Yours sincerely
Angela Brown

Answer
I'm not an expert of diabetes, it is by now around 30 years since I last had anything to do with it and it is also completely outside my area of expertise here. However I suppose that these are routine instructions from the radiologigal department where her CT will take place. So probably they are safe. However this is something she SHOULD discuss with her dr.! I'm sorry she rejected chemo therapy! Though with her diabetes there may have been some problems. Even so I think it had been best - based on your description - if she had accepted chemo therapy and radiation therapy together with (anti) hormonal therapy (in her case an aromatase inhibitor which seems to be better than Tamoxifene, which is a receptor blocker). In my opinion that would probably have been better for her. With regards to her present problem. Has any gynecologist checked her? Or a surgeon? Or an oncologist? Her condition is hardly a case for a GP! It is impossible from afar to have any real opinion of these a bit vague symptoms without an examination. Also those granulomas are not really cancerous so outside my area of expertise here. However it is my firm opinion that your mother is a case for specialists not for any G.P.!