How to cure Metastatic breast cancer - #20471

A 54-years-female patient diagnosed with left side Invasive ductal carcinoma Grade 2 in 2018. ER positive by 80%. The modified radical mastectomy was done. Chemotherapy and radiotherapy was also done. Started Endocrine therapy Tamoxifene 10mg with normal mammography in followup for 3.5 years... But due to vaginal bleeding, TAH+BSSO was done back in January 2023. Switched to another endocrine therapy Letrozole 2.5mg after it. She developed swelling around frontoparietal region and in December 2023, oncologist recommended Bone scan which revealed radiotracer uptake in frontoparietal region, 3rd rib anteriorly, pubic area, S1 sacral and pedicle of T8. 4mm stable nodule in lower left lobe of lung.. Luckily, CT Scan of Chest abdomen and pelvis was negative with 4mm stable lung nodule in lower left lobule of lung. PET Scan in February 16th, 2024 revealed the same as of bone scan. Which means there are multiple osteolytic lesions (bone mets). The oncologist has prescribed targeted therapy Palbociclib 125 mg and endocrine therapy Exemestane 25 mg (instead of Letrozole). Patient has symptoms of back pain when gets up early in the morning and pain in head often, the pain is relieved with Paracetamol..... Now recent bone scan, CT Scan (CAP) and MRI (Brain) reports are shared.... Based on recent scans after 10-11 months, CT scan showed progression in lungs with mutiple (6-7) nodules in both lungs.. Bone scan shows, increase in intensity of previously noted lesions with appearance of new lesions right scapula and sacrum.. MRI Brain shows Multifocal variable-sized enhancing aggressive osseous masses in visualized skull,largest one in right temporal bone with associated enhancing infiltrative intracranial and extracranial components and suspicion of dural infiltration by its intracranial component;consistent with patien's known osseous metastasis. Few small'T2/FLAIR bright signal foci in bilateral periventricular and subcortical white matter. No definite enhancing intraparenchymal mass or nodule and Pansinusitis. The oncologist has recommended to switch hormonal therapy from Exemestane to Fulvestrant and continue targeted therapy Palbociclib (CDK 4/6 inhibitor)