This sounds like a tough situation. I will offer up an opinion but I know others will have their thoughts and more than one is important here. Obviously, this person is at very high risk to have occult metastatic disease. However, I think this biology is also interesting. For a tumor to have reached...

Thank you for taking the time to write such a thoughtful helpful answer. Assume this is ductal and not metaplastic. Recommend NGS to look for targets beyond chemo and also basal markers. I am concerned that xeloda is not going to be effective here esp if basal type which we expect. Trodelvy or enher...

In my day of hyperthermia, I had some referrals like this.  I had 2 patients in particular where I treated to 70 Gy with hyperthermia and cisplatin (in those days we believed that hyperthermia enhanced cisplatin dose).  One patient in particular had a durable complete response (I saw her a...

Skin infection in these patients can sometimes conceal advancing skin involvement. If the medical oncologists have the opinion that treatment results have stagnated for this patient then it would seem reasonable to begin a course of high dose durable palliative radiotherapy to the areas of involveme...