Hi! I’m not sure if its right place to ask such a question… forgive me if I made a mistake 
Problem is, medicine in our country is not super reliable, so it’s better to double-check treatments offered by doctors. Also there is a problem of corruption resulting in inadequate treatments. So I try to collect as much information as possible.
My mother (53 y.o.) was diagnosed with breast cancer on 29-Jan-2016.
Preliminary diagnosis: T2N2M0 or T1N1M0 (different opinions - because of biopsy taken from tumor, the tumor has grown twice its size during a week - so you see, already no clear opinion).
I’d be grateful for any opinions of proposed treatment strategy! Especially, about neoadjuvant therapy.
Tumor has been found in the right breast with a size of 1.2cm, lymph node next to it (arm pit area) is oversized (3cm) and the opposite node is also slightly big (2cm).
Biopsy detected invasive ductal carcinoma, with lymph node affected by metastasis.
First IHC: ER: +, PR: +, HER2: 2+, Ki67: 50%; G2 (2+3+1)
Second IHC (revised, with FISH): ER: + (95%, 8 ball), PR: + (80%, 8 ball), Ki67: 60%, Elston&Ellis: (2+2+2)=6
FISH: negative (no amplification of her2/new, for 20 cores of tumor cells: chromosome 17: 25 signals, her2: 50 signals, rate: 1.42)
As for other tests:
- mammography: didn’t detect tumor itself, but detected lymph node problem
- ultrasound: detected tumor and possible metastasis in lymph node (further biopsy confirmed that on right side nodes are grouped in conglomerate, 1 or 2 nodes affected with metastasis)
- osteo scintigraphy: ok (there were some suspicious places on ribs near the breast side, on shoulder, at the back of skull, but repeated scintigraphy and x-ray didn’t show anything bad)
- CT scan (with contrast): same as ultrasound, detected tumor and lymph nodes
- blood tests: ok
- BRCA: one mutation detected (BRCA1 5382insC, others were negative: BRCA1 2080delA(insA), BRCA2 6174delT, BRCA1 4153delA, BRCA1 185delAG, BRCA1 3875del4, BRCA1 3819del5, BRCA1 T300G)
what treatment plan is recommended in this case?
- what kind of neoadjuvant therapy? chemo/hormones?
- what kind of surgery?
- what kind of adjuvant therapy? chemo/hormones?
if neoadjuvant chemo fails, what would be plan B for neoadjuvant period?
Next week my Mom is scheduled to have first chemo, some kind of platinum. as I understand BRCA-1 mutation was the primary cause of this decision. Do you think its right type of chemo?
some say platinum is hard chemo, what can we do to make it less aggressive for health? any special meals? any other practical advice?
thanks in advance!
Anton