Should it have been spotted earlier, is there a cause

My first post, a little history regarding my mum.
My mums 82, and until early this year was fit and active. In March she developed numbness in the bottom of one of her legs, and breathing difficulties, she was eventually admitted to hospital and was very poorly, but after a few weeks of treatment seemed better. The diagnosis was pneomonia causing a sluggish heart which threw off a clot to cause the numbness, tests showed a suspected heart attack at some time. I was never too sure about the pneomonia, she just didnt look like she had it. She was then on the verge of leaving hospital when she was struck down by C-Diff which recurred twice each time weakening her even more. But after treatment and a course of pro-biotics she seemed over that. Then she discovered a large lump under her arm which after tests showed to be secondary breast cancer in her lymph, there was no signs in her breast, various scans have failed to show any signs anywhere else in her body. Radiotherapy appeared to destroy the lump, but unfortunately now one of her breasts has swelled and on examination it appears the lump under her arm is starting to grow again. So on wednesday she is going to start Chemo (Vinorelbine) . So a few point id like to raise, could the cancer have been caused as a reaction to treatment she received while in hospital, was breast cancer the cause of her problems from day one and should it have been spotted earlier. Is Vinorelbine the best treatment she can get, i understand that they are a little limited in what they can use because of her heart problems, but what about Lapatinad, would that be a better option.

Spread to the lymph glands under the armpit is not secondary cancer, you may be pleased to hear.

For a younger woman without heart problems, surgical removal of her lymph glands would be usual. In your mother’s case, they probably decided not to take the risk of surgery and to control the cancer with Vinorelbine instead.

She can live for many years despite the cancer, if it is controlled. Those of us with extensive secondary cancer are living proof of this. Surgery might put too much strain on her heart and kill her.

Probably a good decision.

The doctors definately described it as a secondary cancer?

Women treated for primary cancer frequently have spread to the lymph glands under the armpit. It is one of the factors used to decide the grade of primary breast cancer (grades 1 to 3).

If your mother has secondary breast cancer (grade 4), it means there is spread to a more serious area. Secondary breast cancer usually involves bones, liver, lungs or brain. However you said various scans did not reveal cancer anywhere else in her body. I would suggest you double check this and ask why they termed it as secondary breast cancer.

Hi Jim

You seem to have quite a lot of unanswered questions here, perhaps it may be helpful to you if you would like to give the helpline a ring where you can talk in confidence to the breast care nurses who may be able to answer some of these questions. Our free phone helpline number is 0808 800 6000 the lines are open Monday to Friday 9am - 5pm and Saturdays 9am - 2pm.

Everyone on our helpline either has experience of breast cancer or is a breast care nurse. The team comes from a variety of backgrounds, so callers get to talk to someone who has an understanding of the issues they’re facing.
The team is able to talk about both technical and emotional issues surrounding breast cancer and breast health and are there for not only patients but family and friends like yourself. Hope this helps.

Kind regards,
Jo, Moderator

hello Jim,
I was wondering if you would write about how your Mum does on Vinorelbine.
My Mum is about to start the tablet version & I am nervous for her.
Her oncologist is really playing down side effects but she had quite a rough time on Capecitabine (managed only 2 courses)
She is only 61 but has secondaries in lymph, bones, lung & liver.
Kind Regards.

I am sorry to hear about your mum’s problems.
I’ve had vineralbine and capecetabine and definately vineralbine was easy to tolerate but you have to remember your mum’s age/heart condition does play a factor in what the doctors can offer her safely and how she will react to the chemo.
Lapatinab is not yet licenced and still being trialled but to be eligible for it you need to have had a long list of different chemos first, including a year’s herceptin and so is only suitable for herceptin positive cancer. You also need to have good heart function for it anyway.
I hope she gets on well with the vineralbine and the lump shrinks.
Like Holeybones says, I don’t understand how they say it is secondary breast cancer if it has not spread beyond breast or lymph.Usually, secondary cancer spreads to liver, lungs, bones, brain or other parts of the lymph system other than the armpit eg I have widespread lymph spread in my lungs.
Cancer is graded according to how aggressive it is - does your oncologist mean it is Grade 2? Cancer is also staged so it would be either Stage 2 or 3 cancer…

Hi Jim

So sorry to hear about your mum.

I just wanted to add that in a small number of cases of even primary breast cancer no primary tumour is ever found and the condition has been diagnosed by other symptoms such as underarm swelling. This happened to a friend of mine but they were able to tell by looking at the characteristics of the cancer that it definitely orginated in the breast.

You may want to ask your mum’s consultant exactly what he meant by ‘secondary’ breast cancer. As the other girls have said the term is normally reserved for cancer that has metastacised (spread) to other organs. However in your mum’s case he may have meant that, although it was found in her lymph nodes, it is actually breast cancer that has moved there rather than a condition such as lymphoma which originated in the lymphatic system.

From a completely layman’s point of view I would say it is likely your mum has had undetected/undetectable breast cancer for some time and it has not been caused by her treatment.

If you want me to ask my friend a bit more about her situation and diagnosis please feel free to ask here or send a personal message.

All the best and I hope your mum tolerates the chemo well.


Sometimes the primary can be erradicated by the body’s immune system, so it doesn’t show up in tests, but you can still go on to get secondaries. My mum had brain mets, but we never knew what her primary was as nothing could be found.