Chapter 1782: 1782: Cruelty

Chapter 1782: Chapter 1782: Cruelty

The hesitation of Teacher Du, a few students can understand the reason just by looking at the patient’s medical records.

“The pathology of her tumor, it belongs to the Luminal B subtype.” Du Haiwei read aloud the results of the pathology report written on the medical records.

The family member accompanying the patient, likely the patient’s mother, responded: “Yes, yes, after the surgery the doctor over there received the report and told us that this subtype is not bad, and the treatment effect would be relatively good. I don’t understand why after taking the medicine it’s said that the indicators aren’t coming down.”

“One-third of patients will develop resistance to these drugs, which means they do not achieve the therapeutic effect that doctors intend,” said Du Haiwei. “Her pathology report shows that her tumor is estrogen-dependent, and if these drugs were effective, they could interfere with the estrogen receptor. It seems they have no effect.”

The two students sitting opposite found that Teacher Du doesn’t avoid talking; he absolutely says what needs to be said and is very patient with the patient’s family.

The family member said, “We heard similar words from the breast surgery doctor, who said we need to come to your gynecology department for surgery.”

“She’s too young, with lymph node metastasis. Did the breast surgery doctor discuss these issues with you?” Du Haiwei calmly continued to ask.

Assessing a cancer patient’s condition, including the prognosis, requires a comprehensive analysis of all data. Just looking at the pathological subtype is not sufficient; it is absolutely necessary to also consider staging, the patient’s age, and other factors to make a judgment.

This patient’s supposedly favorable Luminal B subtype is a very delicate situation. The test results show positive estrogen receptor ER, progesterone receptor PR, and negative human epidermal growth factor receptor HER2. These indicators suggest that endocrine therapy might have a targeted effect on this patient’s tumor cells. For breast cancer patients, endocrine therapy is considered the most life-saving method. Clinically, the triple-negative type that most terrifies doctors and patients cannot use endocrine therapy, leading to the lowest survival rate for such patients.

The unfavorable aspect of Luminal B compared to the best Luminal A subtype lies in another indicator, Ki-67, which is not ideal. High Ki-67 represents high proliferative activity of tumor cells, meaning the tumor cells are too active. In this patient’s staging, it is evident from the Ki-67 results: during tumor excision, the tumor was found to be large, with lymph node metastasis, making the staging undoubtedly poor, and a radical surgery was performed. No matter how the surgical procedure is performed, it is impossible to cleanly remove all cancer cells from the patient’s body. The patient is too young, with a fast metabolism, significantly increasing the likelihood of tumor recurrence. Considering all factors and based on the doctor’s clinical experience, the prognosis for this patient is not promising.

“The doctor over there mentioned it,” the family member said, bowing their head, their voice filled with sorrow.

“After cutting it out, the tumor might continue to recur. If that’s the case, are you sure you want her to go through another surgery?” Du Haiwei asked.

Sometimes the cruelest part of being a doctor is having to explain these consequences repeatedly to patients and their families.

The patient’s mother wiped away the tears at the corner of her eyes and said the heaviest words: “Doctor, she’s just in her early twenties.”

Regarding the topic of young people falling ill, doctors know best, encountering countless cases every day. Like Student Pan’s peer before. Teacher Du has seen so many that he has become numb to it.