CONTACTS 

SUBJECTS
Meeting at Kaiser Agenda Progress Beginning 4th Treatment Cycle

0503 -
0503 -    ..
0504 - Summary/Objective
0505 -
050501 - Follow up ref SDS 36 0000. ref SDS 31 0000.
050502 -
050503 - Patient cleared for next cycle on the Avastin trial based on favorable
050504 - response to treatment shown by CA 15-3 (except later in day, new test
050505 - report shows CA 15-3 has shot up again), ref SDS 0 GJ5M  Favorable
050506 - bone scan report reversing prior finding by PET scan report of
050507 - possible metastasis, needs verification with follow up tests.
050508 - ref SDS 0 6P42  Medicine helping to reduce side effects of continual
050509 - coughing and heaviness in chest causing difficult breathing.
050510 - ref SDS 0 RZ4I  Examination shows lumps under left arm are smaller,
050511 - responding to chemotherapy treatment. ref SDS 0 MW8J
050512 -
050513 -     [On 040811 Millie received the report on the CT test dated 040710.
050514 -     ref SDS 39 DU9I, and shows significantly reduced size of swollen
050515 -     lymph nodes. ref SDS 39 WV66  Appear to be errors in reporting
050516 -     that fails to account for problems cited in prior report.
050517 -     ref SDS 39 WW53
050519 -      ..
050520 -     [On 040812 meeting at Kaiser the doctor explains patient faces
050521 -     difficult dilemma. ref SDS 40 0001
050522 -
050523 -
050524 -
050525 -
050526 -
050528 -  ..
0506 -
0507 -
0508 - Progress
0509 -
050901 - Meeting Truncated Delay 30 Minutes Not Enough Time for Agenda
050902 -
050903 - The doctor apologized for being 30 minutes late to the meeting
050904 - scheduled for 1000 -- he arrived about 1030, and so there was not
050905 - enough time to complete the agenda, because Millie had treatment
050906 - scheduled in the Chemotherapy Clinic for 1030.
050907 -
050908 -
050909 -
050910 -
0510 -

SUBJECTS
CA 15-3 Cancer Marker 47 Drops from 55 Consistent with CT Testing Sh
CA 15-3 Cancer Marker 47 drops from 55 Continuing Trend Shows Respon
CA 15-3 70 Rises from 60 Reversing Trend of Past 6 Months
CA 15-3 Cancer Marker 78 Rises from 70 Indicating Potential Cancer A

1906 -
190701 -  ..
190702 - Recovery Progress CA 15-3 Cancer Marker Drops to 47 from 55
190703 - CA 15-3 Cancer Marker Continues Falling Consistent with Treatment Plan
190704 -
190705 - Follow up ref SDS 36 087J, ref SDS 31 087J.
190707 -  ..
190708 - CA 15-3 blood test shows another significant drop to 47 from 55.
190710 -           ..
190711 -          040628......... 47 H............. 040713, ref SDS 0 087J
190712 -          040614......... 55 H............. 040615, ref SDS 37 PX6X
190713 -          040517......... 78 H............. 040601, ref SDS 33 2N5J
190714 -          040311......... 70 H............. 040318, ref SDS 24 SM6M
190715 -          040205......... 60 H............. 040211, ref SDS 22 SM6M
190716 -          031201......... 62 H............. 031205, ref SDS 21 SM6M
190717 -          030912......... 66 H............. 030915, ref SDS 20 SM6M
190718 -          030708......... 68 H............. 030710, ref SDS 19 SM6M
190719 -          030503......... 54 H............. 030508, ref SDS 17 SM6M
190720 -          030403......... 45 H............. 030508, ref SDS 17 SM6M
190721 -          030215......... 46 H............. 030220, ref SDS 16 5E6L
190722 -          030106......... 37 H............. 030109, ref SDS 15 SM6M
190723 -          021202......... 41 H?............ 021204, ref SDS 13 SP5G
190724 -          021111......... 36 H?............ 021113, ref SDS 12 Y65I
190725 -          021023......... 33 H?............ 021023, ref SDS 11 SQ5I
190726 -          020930......... 33 H?..29........ 021002, ref SDS 10 SQ5I
190727 -          020917......... 36 H?............ 020924, ref SDS 9 SQ5I
190728 -          020717......... 59 H?............ 020726, ref SDS 8 YN5K
190729 -          020629......... 75 H ............ 020705, ref SDS 7 UX6I
190730 -          020608........  67 H ............ 020614, ref SDS 6 0001
190731 -          020603........ 108 H ............ 020607, ref SDS 5 X67F
190732 -          020511........ 117 H ............ 020603, ref SDS 4 PJ4J
190733 -          020419......... 81 H ............ 020430, ref SDS 3 7N5H
190734 -          020321......... 85 H ............ 020405, ref SDS 2 6T8K
190735 -
190736 -
190737 -
190739 -  ..
1908 -
1909 -
1910 - Analysis
1911 -
191101 - CA 15-3 Cancer Marker Shows Patient Responding to Treatment
191102 -
191103 - Follow up ref SDS 36 GJ5M, ref SDS 31 GJ5M.
191104 -
191105 - The doctor commented that CA 15-3 indicates patient is responding to
191106 - treatment.
191107 -
191108 -     [...later in the day CA 15-3 report on blood drawn yesterday,
191109 -     040712, and received while getting treatment in the Chemotherapy
191110 -     Clinic after meeting with the doctor, shows rise from 47 to 54.
191111 -     ref SDS 38 2N5J
191112 -
191113 -
191114 -
191115 -
191116 -
1912 -

SUBJECTS
Arthritic Degenerative Change Shown by Bone Scan Report 11th Left Po
Bone Scan Test Results Show No Evidence Metastatic Cancer
Bone Scan Schedule for 2nd Opinion Review by Tumor Board
Bone Scan Test Results Show No Evidence Metastatic Cancer 11th Left

2606 -
260701 -  ..
260702 - PET Abnormality Not Supported by Bone Scan
260703 - Arthritic Conditions Shown by Bone Scan PET Abnormality Not Supported
260704 - Bone Scan Test Results Show No Evidence Metastatic Cancer
260705 - Cancer Metastatic No Evidence Shown Bone Scan Test Results
260706 -
260707 - Follow up ref SDS 36 L34N, ref SDS 31 L34N.
260708 -
260709 - Background on bone scan test is reported on 040517. ref SDS 31 L34N
260710 -
260711 - The doctor submitted report on bone scan taken 040429...
260712 -
260713 -    Patient                                          Exam 1 of 1
260719 -     ..
260720 -    Whole Body Scan (Digital)
260724 -     ..
260725 -    History
260727 -     ..
260728 -    Recurrent breast cancer.  Staging evaluation requested.
260730 -     ..
260731 -    RADIOPHARMACEUTICAL:  Tc-99m HDP, 24.8 mCi IV
260733 -     ..
260736 -     ..
260737 -    TECHNIQUE:  Whole body scintiphotos were obtained approximately 2
260738 -    hours post radiotracer injection.
260740 -     ..
260741 -    COMPARISON:  Whole body bone scan 020402 and Body FDG PET study
260742 -    021218.
260744 -  ..
260745 - PET scan on 021228 was reported to the patient during a meeting at
260746 - Kaiser on 030109. ref SDS 15 LK5L
260748 -  ..
260749 - Bone Test report continues...
260750 -
260751 -    FINDINGS
260753 -     ..
260754 -    Whole body sketal images demonstrate physiologic distribution of
260755 -    the radiotracer throughout the bony skeleton.  Minor nonspecific
260756 -    asymmetric activity is identified involving the right
260757 -    sternoclavicular region.  This asymmetry may be in part due to
260758 -    overlapping bony structures vs degenerative changes.  Moderate
260759 -    posterolateral aspect of L5.  This appears slightly more prominent
260760 -    when compared to the prior whole body bone scan, however the
260761 -    location of this finding is most consistent with degenerative/post
260762 -    stress changes.  Stable increased uptake is also identified
260763 -    involving the first carpal-metacarpal joint consistent with
260764 -    arthritic/degenerative change.  No other definite focal
260765 -    scintigraphic abnormalities are identified.
260767 -     ..
260768 -    Specifically no increased uptake is identified involving the left
260769 -    posterior 11th rib to correspond to the PET abnormality identified
260770 -    in this region.
260772 -     ..
260773 -    IMPRESSIONS
260775 -     ..
260776 -    Whole body bone scan demonstrating no definite evidence of bony
260777 -    metastatic disease.  Nonspecific updateis identified infvolving
260778 -    the right posterolateral aspect of L5 which appears slightly more
260779 -    prominent compared to the prior whole body bone scan.  The
260780 -    location of this finding is most consistent with degenerative/post
260781 -    stress change.  Mild asymmetry is also identified infvolving the
260782 -    right supraclavicular regionj as described above.
260784 -        ..
260785 -    J. Yun, MD
260787 -     ..
260788 -    DD  040429  DT  040503   DJH
260790 -  ..
260791 - The doctor noted the Bone scan test report "Impression" that no
260792 - evidence of metastatic disease is a "dot" indicating the patient is
260793 - responding to treatment.
260795 -  ..
260796 - Report today reversing prior PET scan findings of possible metastasis
260797 - in 11th rib, ref SDS 0 I29L, and which was received on 030109,
260798 - ref SDS 15 7G90, seems important enough to verify with cross testing,
260799 - per history of CT tests on Avastin trial, per below. ref SDS 0 LK5L
260800 -
260801 -
260802 -
260803 -
260804 -
260805 -
260806 -
2609 -

SUBJECTS
Breathing Problem Continuous Coughing for Several Hours Heavy Chest

3003 -
300401 -  ..
300402 - Coughing Heaviness in Chest Side Effect Taxol and Avastin Trial
300403 -
300404 - Follow up ref SDS 36 RZ4I, ref SDS 31 RZ4I.
300405 -
300406 - The doctor asked how the cough medicine is working?
300408 -  ..
300409 - Millie advised that cough medicine has helped relieve the sore throat
300410 - from continual coughing to clear her thoat, first reported on 040607.
300411 - ref SDS 34 MP6J  Heavy chest, shortness of breath, easily tiring all
300412 - continue, as reported in the letter to Kaiser on 040610, ref SDS 35
300413 - OH5U,
300415 -  ..
300416 - There was not enough time to review side effects of Avastin trial
300417 - chemotherapy treatments, because Millie was late for treatment in the
300418 - Infusion Clinic, due to starting the meeting 30 minutes late.
300419 - ref SDS 0 RO5I
300420 -
300421 -     [On 040812 Genentec, manufacturer of Avastin announces increased
300422 -     risk from Avastin for pulmonary emboli (blood clots); Millie
300423 -     reports family history of blood clot issues, and asks about report
300424 -     in connection with symptoms of coughing, difficult breathing,
300425 -     heaviness in chest; doctor interprets increased risk on Avastin
300426 -     trial related to personal history of blood clots, and so no change
300427 -     in treatment was prescribed. ref SDS 40 RZ4I
300429 -      ..
300430 -     [On 041104 coughing and heaviness in chest diagnosed due to blood
300431 -     clot (pulmonary emboli) reported in CT test, and which is a side
300432 -     effect of Avastin (Bevacizumab) listed in the record on 040517,
300433 -     ref SDS 31 ML8J; Millie removed from Avastin trial; all cancer
300434 -     treatments suspended. ref SDS 41 N43I
300435 -
300436 -
300437 -
300438 -
300439 -
300440 -
3005 -

SUBJECTS
Meeting with Doctor about Lump in left breast and Under Left Arm Cau
Swelling Left Side Under Left Arm Likely Caused by Draining Lymph No
Symptom New Lump Under Arms where Cancer Surgery Performed on 020312
Pea-like Cluster and Firmness Indicates Cancerous Lumps Not Present
Arm Lump Swelled Lymph Nodes Under Left Arm Seem Bigger Again Testin
Lumps Under Arm Swelled Lymph Nodes Symptom Inflammatory Breast Canc
Lumps Under Left Arm Less Severe Demonstrate Favorable Response to T

4009 -
401001 -  ..
401002 - Lumps Under Arm Seem Less Severe Today
401003 -
401004 - Follow up ref SDS 36 MW8J, ref SDS 31 MW8J.
401005 -
401006 - The doctor examined the lump under the left arm.
401008 -  ..
401009 - The doctor agreed that the lump seems much smaller today than found by
401010 - examination conducted during the meeting on 040517. ref SDS 31 MW8J
401011 - The doctor attributed improvement to favorable response to treatment,
401012 - which justifies continues participation in the Avastin trial.
401014 -  ..
401015 - The doctor had not seen background on this matter listed in the record
401016 - of the meeting on 040517, ref SDS 31 SU7G, submitted via email on
401017 - 040610 to enable the doctor to prepare for meeting on 040614, and
401018 - which did not occur, evidently because Kaiser's computer was "down."
401019 - ref SDS 36 MW8J
401021 -  ..
401022 - Favorable response to chemotherapy treatment indicates diagnosis of
401023 - lumps under the left arm as scar tissue, reported on 030606,
401024 - ref SDS 18 Y45M, was different from cancer responding to Taxol and
401025 - Avastin.
401026 -
401027 -
401028 -
401029 -
401030 -
401031 -
401032 -
4011 -

SUBJECTS
Lumps Neck Seem to Have Become Softer Smaller Suggest Possible Favor
Lumps Neck Gone Clinical Examination
Lumps Neck Only Evidence Metastatic Cancer Symptom IBC

5705 -
570601 -  ..
570602 - Lumps in Neck Not Evident from Clinical Examination No Stiffness Pain
570603 - Metastatic Cancer Diagnosed Based on Lumps in Neck of IBC Patient
570604 -
570605 - Follow up ref SDS 36 8R6M, ref SDS 31 8R6M.
570607 -  ..
570608 - There have been no more episodes of pain and stiffness in the neck,
570609 - originally reported on 040517, and explained at that time as possible
570610 - evidence of effective treatment. ref SDS 31 8R6M
570612 -  ..
570613 - The doctor examined Millie's neck by pressing his fingers in the areas
570614 - were lumps were previously swelled, and today agreed with Millie that
570615 - swelling is further reduced from the examination on 040614.
570616 - ref SDS 36 8R6M, because the lumps in the neck are no longer present,
570617 - continuing findings of favorable response to treatment reported on
570618 - 040517. ref SDS 31 3R6O
570620 -  ..
570621 - Key issue seems to be whether there is metastatic cancer.
570623 -  ..
570624 - The doctor seemed to confirm that he has diagnosed metastatic cancer,
570625 - and that the basis of this diagnosis is the pathology report reviewed
570626 - on 040318 that found the biopsy taken on 040303 to test new lumps in
570627 - the neck were positive for cancer. ref SDS 24 8R6M   Additionally, the
570628 - biopsy from the original surgery on 020312, and received during a
570629 - meeting on 020321 expressly diagnoses metastatic disease. ref SDS 1
570630 - 4U8X
570631 -
570632 -     [On 040812 confirmed understanding that lumps in the neck
570633 -     diagnosed on 040309, and under the arm are evidence of regional
570634 -     metastatic cancer, which are symptoms of IBC. ref SDS 40 QT7O
570636 -  ..
570637 - The doctor noted there is no other evidence of cancer in all the
570638 - tests, e.g., xray, bone scans, CT tests.
570640 -  ..
570641 - On 040517 research indicates cancerous lumps in the neck are symptoms
570642 - of IBC. ref SDS 31 AF7G
570643 -
570644 -
570645 -
570646 -
570647 -
570648 -
570649 -
5707 -

SUBJECTS
Redness Returns to Left Breast Diagnosed as Cellulitus Treated with
Breast Softer Change May Indicate Recovery from Trauma of Surgery
Diagnosis Changed from Cellulitus to Radiation Reaction Treated with
Cancer Treatment Delayed Cellulitus Diagnosed Treated with Antibioti
Breast Redness Returns to Left Breast Diagnosed as Cellulitus Treate
Breast Redness Diagnosis Changed from Cellulitus to Radiation Reacti
Biopsy Pathology Report Diagnosed Inflammatory Breast Cancer Submitt
Pathology Report on Biopsy Diagnosed Inflammatory Breast Cancer Subm
Inflammatory Breast Cancer Rare 1% of Cases Aggressive Spreads Quick
Treatment Chemotherapy Masectomy Surgery Radiation Initially Reduce   7
Treatment Chemotherapy Masectomy Radiation How Inflammatory Breast C
Time Not Enough for Examination to Evaluate Symptoms IBC Reduced Red

7714 -
771501 -  ..
771502 - Inflammatory Breast Cancer (IBC) Diagnosed Based on Pathology Report
771503 - Redness Breast Seems Less Severe; Skin Seems Softer after Treatments
771504 -
771505 - Follow up ref SDS 36 6T5G, ref SDS 31 6T5G.
771506 -
771507 - The doctor seemed to say today that reduction of redness in the skin
771508 - and softening of thickened skin shown by clinical examination signal
771509 - breakup of the tumor, which is the key criteria for establishing
771510 - regression of IBC and that disease has subsided enough for surgery,
771511 - planned on 040429, ref SDS 29 SD7F, and noted again by the doctor on
771512 - 040502. ref SDS 30 MG8G
771514 -  ..
771515 - There was not enough time for a clinical examination today.
771516 -
771517 -
771518 -
771519 -
771520 -
771521 -
7716 -

SUBJECTS
PET Scan Findings Show Previous Metastatic Lymphadenopathy No Longer
Metastasis New Nonspecific May be Post Treatment Trauma Inflammatory
CT Scan Performed for Comparison with PET Scan to Evaluate New Metas
CT Scan Findings Show Previous Metastatic Lymphadenopathy No Longer
CT Scan Findings Show 2 New 1 CM Masses in Area of Prior Surgery for
Distant Metastasis Not Reported in CT Test on 030508
CT Scan Findings Show 1 CM Masses Increased to 1.5 CM 50% Growth
CT Scan Test Ordered Instead of PET Scan Test and Compare with Origi
CT Scan Test Shows No Evidence Progression Distant Metastasis Stable
CT Test Final Version Marked Addendum Pending Not Finalized Mistake
CT Test Analysis on 040416 Finding Cancer Metastasis Limited to Neck
CT Test Time Not Enough Review Discuss Submit Report Showing Respons

8914 -
891501 -  ..
891502 - Cancer Neck Only Evidence of CT Scan Shows Distant Metastasis
891503 - CT Scan Shows Evidence of Distant Metastasis Carcinoma Only in the N
891504 -
891505 - Follow up ref SDS 36 LK5L, ref SDS 31 LK5L.
891506 -
891507 - The doctor said there is not enough time today to review, discuss, and
891508 - submit the report on the CT test taken on 040710.  He will have the
891509 - staff submit the report by mail later today.
891510 -
891511 -     [On 040811 Millie submitted letter to Rosalie asking the staff to
891512 -     remind the doctor to submit the report on the CT test, so that
891513 -     this can support preparing for the meeting with the doctor on
891514 -     040812. ref SDS 39 ES4Y
891516 -      ..
891517 -     [On 040811 Millie received the report on the CT test dated 040710.
891518 -     ref SDS 39 DU9I  Report shows significant reduced size of swollem
891519 -     lymph nodes. ref SDS 39 WV66  Appear to be errors in reporting
891520 -     that fails to account for problems cited in prior report.
891521 -     ref SDS 39 WW53
891523 -  ..
891524 - Finding in bone scan report received today that reverses prior PET
891525 - scan report, ref SDS 0 I29L, received on 030109 that previously found
891526 - abnormality in 11th rib that could be metastasis, ref SDS 15 7G90,
891527 - seems important and should be verified with cross testing. ref SDS 0
891528 - FP5L
891529 -
891530 -
891531 -
891532 -
891533 -
891534 -
891535 -
891536 -
891537 -
891538 -
891539 -
8916 -