A 47 yr old premenopause women presented with right side breast lump for 5 months was diagnosed as breast carcinoma and operated before 18 months... chemotherapy and radiotherapy was completed... now she is in hormonal therapy (tamoxifen) and presented with c/o right side body pain and can't able to sleep with right lateral position and pain during lifting arm for past 4 months.....she came to hospital and PET scan was taken as per the patients request and that reports are attached here... can anyone explain me why she got cancer metastasis in lymph nodes, liver, Femur inspite of chemotherapy radiotherapy and hormonal therapy ?????????????????????? initial stage- TxN1Mo (5/13 nodes) tumor biology - ER negative, PR positive, Her2 negative.

It is a reality in cancer treatment. Even if we give all modalities of treatment as in this case,there is no guarantee of cure. That is why we assess 5 yr survival rate in malignancies than complete cure.
Ok sir .... Now how many chemo are needed ??
What was the initial stage of the disease It all depends on the stage and tumour biology
TxN1Mo (5/13 nodes) ER negative, PR positive, Her2 negative sir