Chapter 1782 【1782】Cruel
Teacher Du's hesitation, several students can understand the reason just by looking at the patient's medical records.
"Her tumor was pathologically determined to be of Luminal B type." Du Haiwei read the results of the pathology report written in the medical records.
The family member who accompanied the patient should be the patient's mother, and said: "Yes, yes, the doctor over there got a report after the operation and told us that the classification is good and the treatment effect will be better. No I know why the indicator doesn’t drop after taking the medicine.”
"One-third of the patients will develop resistance to these drugs, that is to say, after taking them, they will not produce the therapeutic effect that the doctor wants to achieve." Du Haiwei said, "Her pathology report shows that the tumor in her body is Estrogen-dependent, these drugs, if effective, can interfere with estrogen receptors. Now it seems that they are not effective."
The two students sitting across from each other found that Mr. Du was not a talkative person, he would definitely say what he had to say, and he was very patient with the patient's family members.
The family member said: "We heard these words from the breast surgery doctor, saying that we need to come to your gynecology department for surgery."
"She is too young, and her lymph nodes have metastasized. Has the breast surgeon discussed these issues with you?" Du Haiwei continued to ask in a steady voice.
Judging the condition of a cancer patient, including the prognosis, requires a comprehensive analysis of all the data. It is not enough to only look at the pathological type, and it is absolutely necessary to combine factors such as stage and patient age to make a judgment.
The so-called Luminal B type of this patient is a very delicate 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 that endocrine therapy may have a targeted effect on the tumor cells of this patient. For breast cancer patients, endocrine therapy can be said to be the most life-saving method. For example, Sanyin, which is the most frightening for doctors and patients in clinical practice, does not need endocrine therapy, so the survival rate of such patients is the lowest.
The worst thing about Luminal B type compared to the best Luminal A type is that another indicator, Ki-67, is not very good. High Ki-67 represents the status of tumor cell proliferation. The high expression of tumor cell proliferation in the body is too active. Therefore, in the staging of this patient, we can see the results shown in Ki-67: the tumor was found to be large in size and had lymph node metastasis during tumor resection, and the staging was 100% unfavorable, and radical surgery was performed. It is definitely impossible to cut all the cancer cells in the patient's body by how to cut them surgically. The patient is too young, has a fast metabolism, and the possibility of tumor cell recurrence is too high. Taken together, according to the doctor's clinical experience, the prognosis of this patient is not ideal.
"I heard from the doctor over there." The head of the family member hangs down, and the voice is full of sorrow.
"After the incision, the tumor may continue to recur. If this is the case, are you sure you want her to be inflicted again?" Du Haiwei asked.
Sometimes the cruelest thing about being a doctor is that you have to explain these consequences to patients and their families repeatedly.
Wiping the tears from the corners of the eyes with the patient's mother's hand, she said the heaviest words: "Doctor, she is only in her early twenties."
Doctors know best about the topic of young people's illness, and they don't know how many people they encounter every day. Refer to Pan's classmates before. People like Mr. Du are really numb after watching too much.