Received Feb 9, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (PFIZER-BIONTECH)) | PFIZER\BIONTECH | 2 | FE3197 | — |
I was diagnosed at age 48 with aggressive, metastatic breast cancer/Stage IV metastasis (bone, liver, lung); I was diagnosed at age 48 with aggressive, metastatic breast cancer/Stage IV metastasis (bone, liver, lung); I was diagnosed at age 48 with aggressive, metastatic breast cancer/Stage IV metastasis (bone, liver, lung); I was diagnosed at age 48 with aggressive, metastatic breast cancer/Stage IV metastasis (bone, liver, lung); This is a spontaneous report received from a Consumer or other non HCP. A 47-year-old female patient received BNT162b2 (BNT162B2), on 17Jan2022 as dose 2, single (Lot number: FE3197) at the age of 45 years for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: BNT162b2 (Dose 1, single; Lot number: FE3594), administration date: 27Dec2021, when the patient was 45-year-old, for COVID-19 immunization. The following information was reported: BREAST CANCER METASTATIC (medically significant) with onset 28Mar2024, outcome "not recovered", METASTASES TO BONE (medically significant), METASTASES TO LIVER (medically significant), METASTASES TO LUNG (medically significant) all with onset 12Jul2024, outcome "not recovered" and all described as "I was diagnosed at age 48 with aggressive, metastatic breast cancer/Stage IV metastasis (bone, liver, lung)". The event "i was diagnosed at age 48 with aggressive, metastatic breast cancer/stage iv metastasis (bone, liver, lung)" required physician office visit. The patient underwent the following laboratory tests and procedures: Alanine aminotransferase: (09Jan2025) 80, notes: (H); Androgen receptor assay: (09Jan2025) Positive, notes: 2+, 95%; Anion gap: (09Jan2025) 10; Aspartate aminotransferase: (09Jan2025) 53, notes: (H); Basophil count: (09Jan2025) 0.9 %; (2025) 0.07 %; Biopsy: (Mar2024) invasive lobular carcinoma of the right breast; Biopsy liver: (25Jul2024) confirms multi-organ involvement; Blood albumin: (09Jan2025) 4.5; Blood alkaline phosphatase: (09Jan2025) 80; Blood bicarbonate: (09Jan2025) 27; Blood bilirubin: (09Jan2025) 0.3; Blood calcium: (09Jan2025) 9.9; Blood chloride: (09Jan2025) 105; Blood creatinine: (09Jan2025) 1.02; Blood glucose: (09Jan2025) 96; Blood potassium: (09Jan2025) 4.4; Blood pressure measurement: (unspecified date) 121/76; Blood sodium: (09Jan2025) 142; Blood urea: (09Jan2025) 21; Body mass index: (unspecified date) 28.84 kg/m2; Body temperature: (unspecified date) 36.6 Centigrade, notes: Oral; Cancer with a high tumour mutational burden: (09Jan2025) Low; Carbohydrate antigen 15-3: (09Jan2025) 16; (09Jan2025) 16; Diagnostic aspiration: (23Apr2024) confirms invasive breast cancer; DNA mismatch repair protein gene mutation: (09Jan2025) Stable; Eosinophil count: (09Jan2025) 10.9 %, notes: (H); (2025) 0.90 %, notes: (H); Genetic testing: (Nov2024) negative, notes: negative for standard pathogenic drivers (BRCA1/2 Negative, PALB2 Negative), ruling out genetics; Glomerular filtration rate: (09Jan2025) 68; Granulocyte count: (09Jan2025) Unknown results; Haematocrit: (09Jan2025) 41.4; Haemoglobin: (09Jan2025) 13.9; Heart rate: (unspecified date) 75; Human epidermal growth factor receptor test: (Mar2024) Negative; Imaging procedure: (Mar2024) invasive lobular carcinoma of the right breast; "Fingerprint" Evidence: (Nov2024) provides the molecular "smoking gun"; (Nov2024) tumor shows High MYC Expression (85th percentile); (23Apr2024) Stage IV (cT2, cNO, pM1, G2, ER+, PR+, HER2-); (Nov2024) 5 mut/MB, notes: Low; ruling out standard environmental carcinogens; Lymphocyte count: (09Jan2025) 1.55; Lymphocyte count: (09Jan2025) 18.8 %; Magnetic resonance imaging: (Mar2024) Metastatic disease; Mammogram: (Mar2024) abnormality in the right breast; (28Mar2024) spiculated mass in RUQ of Right breast; Mean cell haemoglobin: (09Jan2025) 30.8; Mean cell haemoglobin concentration: (09Jan2025) 33.6; Mean cell volume: (09Jan2025) 91.8; Mean platelet volume: (09Jan2025) 12, notes: (H); Monocyte count: (09Jan2025) 5.7; (2025) 0.47; Neutrophil count: (09Jan2025) 5.21; Neutrophil count: (09Jan2025) 63.3 %; Oestrogen receptor assay: (Mar2024) Positive; Oxygen saturation: (unspecified date) 98; Physical exam: (unspecified date) HEENT: Grossly normal, notes: Mildly red and swollen turbinates. NECK: Without any palpable cervical or supraclavicular lymphadenopathy. LUNGS: Clear to auscultation bilaterally. AXILLAE: Without any palpable adenopathy. BREASTS: Deferred. HEART: Regular rate and rhythm without murmur, gallop or rub. ABDOMEN: Soft, non-tender. No organomegaly or masses. Bowel sounds normoactive. EXTREMITIES: No edema. NEUROLOGIC: Grossly non-focal; PIK3CA-activated mutation: (09Jan2025) Pathogenic Variant, notes: Exon 21p.K111E; Platelet count: (09Jan2025) 274; Positron emission tomogram: (09Jan2025) soft tissue density lesion; (12Jul2024) confirms Stage IV metastasis (bone, liver, lung); Progesterone receptor assay: (Mar2024) Positive; Protein total: (09Jan2025) 8, notes: (H); Red blood cell count: (09Jan2025) 4.51; Red cell distribution width: (28Mar2024) 43.0; (09Jan2025) 12.8; RET gene fusion test: (09Jan2025) Fusion Not Detected; White blood cell count: (09Jan2025) 8.2. Therapeutic measures were taken as a result of breast cancer metastatic, metastases to bone, metastases to liver, metastases to lung. Clinical course: Approximately twenty-eight (28) months after receiving the second dose of the Pfizer-BioNTech COVID-19 vaccine, patient was diagnosed at age 48 with aggressive, metastatic breast cancer disseminated to my liver and bones. The diagnosis has devastated the patient's life, her husband, and their daughter. Patient have lost employment, currently unemployed, and due to frequent physician appointments, hospital visits, and ongoing systemic therapy, she endure debilitating side effects from hormone-blocking medication. These include (persistent nausea, vomiting, and diarrhea, along with more severe complications such as over 60 pounds of weight loss, significant hair loss, loss of nails, bleeding gums, and loosening of teeth). Date-Event: 28Mar2024 Screening mammography identifies abnormalities. 23Apr2024 - Core-needle biopsy confirms invasive breast cancer. 12Jul2024 - PET/CT confirms Stage IV metastasis (bone, liver, lung). 25Jul2024 - Liver biopsy confirms multi-organ involvement. 05Aug2024 - Initiation of aggressive systemic therapy (chemotherapy, targeted agents). 05Nov2024 - (Withheld) Life Sciences Report: Identifies High MYC expression and confirms no hereditary drivers. 09Jan2025 - (Withheld) Clinic Oncology (Exhibit B): Explicitly classifies the cancer as "Stage IV, metastatic de Novo", confirming rapid onset in a patient previously in her "usual state of health". New Objective Evidence from Tumor Profiling and Clinical Staging (Exhibits C & B): (Withheld) Confirmation of "De Novo" Acceleration (Exhibit B): Medical notes from Clinic ( 09Jan2025) explicitly characterize my diagnosis as "Stage IV, metastatic de Novo" "De Novo" Stage IV presentation describes a cancer that appears suddenly in an advanced, metastatic state, without the typical years-long progression from early-stage disease. This clinical classification aligns perfectly with the "Turbo Cancer" phenomenon observed in the literature regarding plasmid-DNA insertional mutagenesis: a rapid, explosive pathogenesis triggered by a specific oncogenic event (vaccination) rather than slow, natural mutation accumulation. The notes further confirm she was in her "usual state of health" immediately prior to this sudden, catastrophic onset. (Withheld) Life Sciences "Fingerprint" Evidence (Exhibit C): tumor profiling report (Nov2024) provides the molecular "smoking gun": No Hereditary Link: My genetic panel is negative for standard pathogenic drivers (BRCA1/2 Negative, PALB2 Negative), ruling out genetics. No Environmental Link: Tumor Mutational Burden (TMB) is Low (5 mut/MB), ruling out standard environmental carcinogens. The "Fingerprint" of Vaccine Injury: tumor shows High MYC Expression (85th percentile). This is significant because the SV40 promoter-the specific contaminant identified in BNT162b2 "Process 2" lots-is a potent enhancer known to drive dysregulated MYC expression. The velocity, severity, and multi-organ pattern of progression are clinically atypical for a patient with no prior cancer history and a negative genetic panel. Lost Earnings & Loss of Earning Capacity - Compensation for income lost since June 2024 and for the diminished ability to earn in the future. Non-Economic Damages - Pain, suffering, emotional distress, loss of enjoyment of life, and the profound impact on my adult daughter's future. The severity of this psychological distress has manifested in significant physical symptoms, including notable loss of hair, loss of weight, the loss of nails, and the loosening of teeth, all of which demonstrate the depth of the emotional and physiological trauma sustained. Patient currently under palliative care because the disease is incurable and in stage IV with metastases to liver and bones. Clinical Notes: 09Jan2025 - Office Visit. PRIMARY MEDICAL ONCOLOGIST: Dr (Withheld), MD. CC Cancer Staging Malignant Neoplasm Of Breast Female Right (HCC) Staging form: Breast, (Withheld) 8th Edition- Clinical stage from 23Apr2024: Stage IV (cT2, cNO, pM1, G2, ER+, PR+, HER2-). She is here for evaluation while on Kisqali, lupron, and letrozole. HOPI (Withheld) is a 48 y.o. with metastatic invasive lobular breast cancer involving the liver and bones who is on active treatment with Kisqali (3 weeks on then 1 week off) since 19Sep2024, lupron every 4 weeks, and daily letrozole since Jan2024. Oncology History Overview Note: The patient was in her usual state of health when she underwent a screening mammogram in Mar2024 which showed an abnormality in the right breast. Subsequent imaging and biopsy revealed invasive lobular carcinoma of the right breast, ER PR positive and HER2 negative. The patient was scheduled for a right mastectomy on 16Jul2024, however MRI of the bilateral breasts was obtained which showed a finding on her liver concerning for Metastatic disease prompting a dedicated liver MRI. Surgery was put on hold. The patient has received all of her care thus far at [withheld] Health. However, states that she was recently informed that [withheld] Health will no longer be in her network. She is seeking care here at Clinic because of this and is also interested in getting a 2nd opinion. 28Mar2024: Screening Mammo w TOMO which showed spiculated mass in RUQ of Right breast. 23Apr2024: Stereotactic biopsy showing invasive lobular carcinoma. Biopsy of the right breast 10 o'clock lesion 4 cm from the nipple, showing invasive lobular carcinoma, grade 2 measuring 13 mm in greatest dimension. No lymphovascular invasion. ER strongly positive 91-100% PR strongly positive 91-100%, HER2 was IHC 2+ and negative by fluorescent in-situ hybridization with a ratio of 1.3 and average HER2 copy number of 2.5, Ki67 >20%. 23May2024 She underwent MRI bilateral breast on which redemonstrated a 2.7 x 2.2 x 2.3 cm dominant mass in the right upper outer breast, 4 cm from the nipple corresponding to a biopsy-proven invasive lobular carcinoma. Also noted were multiple suspicious enhancing small masses and foci involving multiple quadrants of the right breast. There was no MRI evidence of malignancy in the left breast. A 12 hyperintense progressively enhancing lesion in the right hepatic lobe was also noted, but incompletely characterized on this study. Jun2024: Germline testing 'VUS, in the gene CDH1, c.1537C>A (p.Pro513Thr). 03Jul2024:She subsequently underwent MRI of the liver which revealed small bilobar hepatic metastases, with the largest in segment 8 measuring up to 1.5 cm. Specifically, In the right hepatic lobe (hepatic segment VIII) there is a oval-shape lesion measuring 1.4 cm x 1.5 cm x 1.1 cm. This lesion restricted diffusion, is hypointense on Ti, intermediate hyperintensity on 12 and demonstrates postcontrast enhancement. In hepatic segment V there is an additional lesion with the same characteristics measuring 1.1 cm x 1.1 cm x 1.0 cm, and in the left lobe (segment II), there is a similar 0.7 cm 0.6 cm x 0.9 cm lesion. There is associated hepatic attenuation changes within hepatic segment V and VIII. 12Jul2024 The patient underwent a PET scan which demonstrated increased FDG uptake in the right breast corresponding to biopsy confirmed malignancy. There was also increased FDG uptake in the region of the hepatic lesions seen on MRI in segments 5 and 8. Underlying lesions were not well delineated on this non-contrast examination. The lesion previously seen in segment 2 on MRI was not clearly seen on this examination and was without focal increased FDG uptake. This may be because the lesion was below the resolution of the PET. Liver findings overall concerning for metastatic disease. Multiple lytic osseous lesions also demonstrated FDG uptake and are concerning for metastatic disease. There is increased FDG uptake corresponding to a soft tissue density lesion which appears to arise from the superior aspect of the uterus and measures 2.7 x 3.6 x 2.3 cm and with an SUV max of 7.9 (series 5 image 455; series 4, image 228). Also commented on were multiple non-FDG avid sub-centimeter nodules in the lungs. 23Jul2024 patient's outside medical oncology who discuss management between local and local regional disease versus widely metastatic disease. If disease is widely metastatic, they were made aware that goals of care would be palliative. 25Jul2024 Ultrasound-guided biopsy of the right hepatic lesion which confirmed metastatic carcinoma favoring breast primary GATA-3: Positive, CK7: Positive, E-Cadherin: Negative, Hep Par 1: Negative. ER was 91-100% PR 11-20%, HER2 Neu IHC 2+ and negative by fluorescent in-situ hybridization with a ratio of 1.1 and average HER2 copy number of 1.9. Met with Med onc at [withheld] . 02Aug2014: Started tamoxifen. Malignant Neoplasm Of Breast Female Right (HCC). 23Apr2024: Clinical Stage Staging form: Breast, AJCC 8th Edition - Clinical stage from 23Apr2024: Stage IV (cT2, cNO, pM1, G2, ER+, PR+, HER2-) Stage prefix: Initial diagnosis Histologic grading system: 3 grade system. 03Sep2024: Initial Diagnosis Malignant Neoplasm Of Breast Female Right (HCC) Genetic Testing and Tumor Genotyping. Laboratory Result Report: Abnormal results: Overall Interpretation (A) Legend. A - Abnormal InvItae Breast Cancer Stat Panel WI ATM & CHEK2 Genes (Final result) Overall interpretation (Abnormal) Inconclusive. Clinical Summary A Valiant of Uncertain Significance, c.1537CsA (p.Pro513Thr), was identified In CDH1. The CDH1 gene is associated with autosoMal dominant predisposition to diffuse gastitc cancer and lobular breast cancer, collectively known as hereditary diffuse gastric cancer (HDGC) syndrome and autosomal dominant blepharochelloclontic syndrome (BCDS). Not all variants present in a gene cause disease. The clinical significance of the variant(s) Identified in this gene is uncertain. Until this uncertainty can be resolved, caution should be exercised before using this festal to inform clinical management decisions. This variant quailes for complimentary family studies as part of our VUS Resolution Program. Familial VUS testing is recommended If Infomotive family members are available and are likely to provide additional evidence for future variant reclassification. About the Test This diagnostic test evaluates 9 gene(s) for variants (genetic changes) that are associated with genetic disorders. Diagnostic genetic testing, when combined with family history and other medical resutts, may provide Information to clarify Individual risk, support a clinical diagnosis, and assist with the development or a personalized treatment and management strategy. Genes/Loci Tested ATM (NM_000051.3), BRCA1 (NM_007294.3), BRCA2 (NM_000059.3), CDH1 (NM_004360.3), CHEK2 (NM_007194.3), PALB2 (NM 024675.3), PTEN (NM 000314.4), STK11 (NM_000455.4), 1P53 (NM_000546 5) This table represents a complete list of genes analyzed for this Individual, including the relevant gene transcript(s). If more than one transcript Is listed for a single gene, variants were reported using the first transcript listed unless otherwise indicated in the report. An asterisk (') indicates that this gene has a limitation. Please see the Limitations section for details. Results are negative unless otherwise Indicated in the report. Benign and Likely Benign variants are not Included In this report and in spectlIc scenarios variants of uncertain significance in the requisitioned gene(s) may not be included in this report. 19Sep2024: Chemotherapy Ribociclib / Letrozole Start Date: 19Sep2024 (Planned). Secondary Malignant Neoplasm Of Liver And Intrahepatic Bile Duct (HCC). 19Sep2024 - Chemotherapy Ribociclib / Letrozole Start Date: 19Sep2024 (Planned). She is tolerating the letrozole and Kisqali 600mg. She is due to start a new cycle of Kisqali today. ROS ECOG Score-0: Fully active, able to carry on all pre-disease performance without restriction. Fatigue GO-1 intermittent during last week of kisqali; Fever GO; Neuropathy GO; Headaches GO; Ear congestion GO; Alopecia GO-1; has hair thinning; Mucositis GO; Nausea GO-1 intermittent while on Kisqali; no intervention needed; Vomiting GO; Abdominal Pain GO; Diarrhea GO-1; sometimes in the first week on Kisqali; Constipation GO; Chest pain GO; SOB GO; Cough GO; Rhinitis GO; Edema GO; Pain GO; Arthralgia/Myalgia GO-1 some stiffness/aches to her feet; Dysuria GO; Vision changes GO-1 perfect vision prior to treatment and now struggles with farsightedness. Current Outpatient Medications: letrozole (Femara) 2.5 mg tablet, Take 1 tablet (2.5 mg total) by mouth daily. Take with or without food., Disp: 30 tablet, Rfl: 5; ribociclib (Kisqali) 600 mg/day (200 mg x 3) tablet, Take 3 tablets (600 mg total) by mouth daily. 600 mg once daily for 21 days, followed by a 7-day rest period to complete a 28-day treatment cycle, Disp: 63 tablet, Rfl: 11. OBJECTIVE BP 121/76, Pulse 75, Temp 36.6 C (Oral), Ht 167.8 cm, Wt 81.2 kg I Sp02 98%, BMI 28.84 kg/m2. PHYSICAL EXAM: HEENT: Grossly normal. Mildly red and swollen turbinates. NECK: Without any palpable cervical or supraclavicular lymphadenopathy. LUNGS: Clear to auscultation bilaterally. AXILLAE: Without any palpable adenopathy. BREASTS: Deferred. HEART: Regular rate and rhythm without murmur, gallop or rub. ABDOMEN: Soft, non-tender. No organomegaly or masses. Bowel sounds normoactive. EXTREMITIES: No edema. NEUROLOGIC: Grossly non-focal. LAB DATA: Recent Results (from the past 24 hours). Cancer Antigen 15-3 (CA 15-3); Collection Time: 09Jan2025 9:48 AM = Cancer Ag 15-3, (CA 15-3),- 16. CBC with Differential, Blood: Collection Time: 09Jan2025 9:48 AM: Leukocytes- 8.2; Erythrocytes- 4.51; Hemoglobin- 13.9; Hematocrit- 41.4; MCV- 91.8; MCH- 30.8; MCHC- 33.6; RDW CV- 12.8; RDW SD- 43.0; Platelet Count- 12.0 (H); Mean Platelet Volume 12.0 (H); Neutrophils %- 63.3; Immature Granulocytes %-0.4; Lymphocytes %-18.8; Monocytes %- 5.7; Eosinophils %-10.9; Basophils %-0.9; Neutrophils- 5.21; Lymphocytes- 1.55; Monocytes- 0.47; Eosinophils- 0.90 (H); Basophils- 0.07. Comprehensive Metabolic Panel: Collection Time: 09Jan2025 9:48 AM = Potassium, P - 4.4; Sodium, P - 142; Chloride, P - 105; Bicarbonate, P - 27; Anion Gap, P - 10; BUN (Blood Urea Nitrogen), P - 21; Creatinine - 1.02; Estimated GFR (eGFR) - 68; Calcium, Total, P - 9.9; Glucose, P - 96; Protein, Total, P - 8.0 (H); Albumin, P - 4.5; Aspartate - 53 (H); Aminotransferase (AST), P - 53; Alkaline Phosphatase, P - 80; Alanine - 80 (H); Aminotransferase (ALT), P; Bilirubin, Total, P - 0.3. RADIOLOGICAL DATA: Cancer Staging. Malignant Neoplasm Of Breast Female Right (HCC). Staging form: Breast, AJCC 8th Edition- Clinical stage from 4/23/2024: Stage IV (cT2, cNO, pM1, G2, ER+, PR+, HER2-). Current Therapy: Current Disease Status: Not able to assess (baseline visit) 14 of 37. ECOG Performance Status: 0; Intent of Therapy: Palliative; Intent to Change Therapy: Not applicable (baseline or planning visit). Stage IV, metastatic de Novo right breast cancer, invasive lobular carcinoma, ER 91-100% PR 91-100% HER2 Neu IHC 2+ and negative by FISH, with biopsy-proven metastatic disease to the liver, imaging also showing osseous metastases. Diagnosed with biopsy-proven metastatic disease 25Jul2024 Germline genetics: Germline testing VUS, in the gene CDH1, c.1537C>A (p.Pro513Thr). 2024. Somatic NGS: Not performed (NGS will be ordered on liver biopsy) Premenopausal. Patient is tolerating the current regimen well. Her clinical exam is stable and her labs are satisfactory. Ca 15-3 is 22. PLAN: Metastatic breast cancer.-continue daily letrozole-continue ribociclib 600mg daily (3 weeks on then 1 week off)-due to start a new cycle today-continue lupron every 4 weeks- next due 24Oct2025. may consider BSO once response is obtained later on.-05Nov2024 CARTS testing on outside liver biopsy from [withheld] Health 25Jul2024 showed: Results with Therapy Associations. Biomarker- ERBB2 iHer2/Neuj; Method- INC; Analyte- Protein; Result- HER2-Low Score 1+; Therapy Associations- BENEFIT- fn-tristuzumab deruxtecaprotkil; Biomarker level- Lev I. Biomarker- ER; Method- IHC; Analyte- Protein; Result- Positive 12+, 95%; Therapy Associations- BENEFIT- abernaddlb, palbocidlb, ribociab, endocrine therapy, cwerolhous; Biomarker level- Level 2. Biomarker- ER/PR/Heil/Neu Method- INC Analyte- Protein Result- I-IR-Positive HER2-Low Therapy Associations- BENEFit- sadtuzumab qovitecan Biomarker level- Level 2 Biomarker- PIK3CA Method- Seq Analyte- ONA-Tumor Result- Pathogenic variant exon 21 Ph 10.47 r Therapy Associations- BENEFIT - alpellsib + fulvedrant, capbasertlb + futvestrant Inavofillb* fulvestrant + Palbodtlib Biomarker level- Level 2 Biomarker- PR Method- IHC Analyte- Protein Result- Positive 1+, 30% Therapy Associations- BENEFIT- Dimmed db. palbodd lb, ribocIdib - Level 2 endocrine therapy Biomarker level- Level 2 -Plan for restaging PET-CT and MRI abdomen 3 months after initiation of ribociclib-was 19Dec2024 but patient requested to have these appointments pushed back one month and currently scheduled on 27Jan2025. # Potential for prolonged QTc-05Sep2024 baseline EKG with QTc 385 and NSR-02Oct2024 EKG with QTc 401 and SB-17Oct2024 EKG SB with QTc 406-no further EKG needed unless patient symptomatic # Bone mets.-plan for IV zoledronic acid every 12 weeks once we have dental clearance-pt reports she will need either an extraction or root canal with crown to her L lower molar per her dentist and she was supposed to see them in Dec2024 but had issues with insurance and needs to reschedule. Will assist with a letter for dental clearance. # Uterine mass on PET/CT-12Jul2024 outside PET/CT showed a soft tissue density lesion which appears to arise from the superior aspect of the uterus and measures 2.7 x 3.6 x 2.3 cm.-TV/TA US 19Sep2024 showed Left adnexal/uterine finding is not well characterized sonographically but remains suspicious given prior PET activity. Additional pelvic findings, including a 2.5 cm endometrial intracavitary fibroid/mass and right ovarian cyst and teratoma. Recommend MR Pelvis for further characterization.-Awaiting updated imaging and may need to consider GYN consultation. Follow up in two weeks for restaging. Patient is aware of the plan and agrees. She will call for any interim issues. Follow up with her PCP for health maintenance and any screenings. #1 Malignant Neoplasm Of Breast Female Right (HCC). #2 Secondary Malignant Neoplasm Of Liver And Intrahepatic Bile Duct (HCC). #3 Other Long Term Current Drug Therapy. Other orders- Oncology office visit (clinic). Cancer Antigen 15-3 (CA 15-3); Future; Expected date: 21Feb2025, CBC with Differential, Blood; Future; Expected date: 21Feb2025, Comprehensive Metabolic Panel; Future; Expected date: 21Feb2025, Oncology office visit (clinic); Future; Expected date: 21Feb2025, Cancer Antigen 15-3 (CA 15-3); Future; Expected date: 21Mar2025, CBC with Differential, Blood; Future; Expected date: 21Mar2025, Comprehensive Metabolic Panel; Future; Expected date: 21Mar2025, Oncology office visit (clinic); Future; Expected date: 21Mar2025, Cancer Antigen 15-3 (CA 15-3); Future; Expected date: 18Apr2025, CBC with Differential, Blood; Future; Expected date: 18Apr2025, Comprehensive Metabolic Panel; Future; Expected date: 18Apr2025, Oncology office visit (clinic); Future; Expected date: 18Apr2025. Biomarker reporting classification: Level 1 -Companion diagnostic (CDx); Level 2- Strong evidence of clinical significance or is endorsed by standard clinical guidelines; Level 3 - Potential clinical significance. Bolded benefit therapies. if present, highlight the most clinically significant findings. Important Note: For information on GPSai'm, please refer to relevant section of the report. Sacituzumab govitecan is FDA-approved for Jnresectable locally advanced or metastatic HR-positive, HER2-negatwe/low breast cancer patients who have received endocrine-based therapy and at least two additional systemic therapies in the metastatic setting.
Test Date: 20250109; Test Name: Alanine aminotransferase; Result Unstructured Data: Test Result: 80; Comments: (H); Test Date: 20250109; Test Name: AR; Test Result: Positive; Comments: 2+, 95%; Test Date: 20250109; Test Name: Anion Gap; Result Unstructured Data: Test Result:10; Test Date: 20250109; Test Name: Aspartate; Result Unstructured Data: Test Result: 53; Comments: (H); Test Date: 20250109; Test Name: Basophils; Test Result: 0.9%; Test Date: 2025; Test Name: Basophils; Test Result: 0.07%; Test Date: 202403; Test Name: biopsy; Result Unstructured Data: Test Result: invasive lobular carcinoma of the right breast; Test Date: 20240725; Test Name: Liver biopsy; Result Unstructured Data: Test Result: confirms multi-organ involvement; Test Date: 20250109; Test Name: Albumin; Result Unstructured Data: Test Result:4.5; Test Date: 20250109; Test Name: Alkaline Phosphatase; Result Unstructured Data: Test Result: 80; Test Date: 20250109; Test Name: Bicarbonate; Result Unstructured Data: Test Result: 27; Test Date: 20250109; Test Name: Bilirubin; Result Unstructured Data: Test Result:0.3; Test Date: 20250109; Test Name: Calcium; Result Unstructured Data: Test Result: 9.9; Test Date: 20250109; Test Name: Chloride, P; Result Unstructured Data: Test Result:105; Test Date: 20250109; Test Name: Creatinine; Result Unstructured Data: Test Result:1.02; Test Date: 20250109; Test Name: Glucose; Result Unstructured Data: Test Result: 96; Test Date: 20250109; Test Name: Potassium, P; Result Unstructured Data: Test Result:4.4; Test Name: BP; Result Unstructured Data: Test Result:121/76; Test Date: 20250109; Test Name: Sodium; Result Unstructured Data: Test Result: 142; Test Date: 20250109; Test Name: BUN; Result Unstructured Data: Test Result: 21; Test Name: BMI; Result Unstructured Data: Test Result: 28.84 kg/m2; Test Name: Temp; Result Unstructured Data: Test Result: 36.6 Centigrade; Comments: Oral; Test Date: 20250109; Test Name: Tumor Mutational; Result Unstructured Data: Test Result: Low; Test Date: 20250109; Test Name: Cancer Ag 15-3; Result Unstructured Data: Test Result:16; Test Date: 20250109; Test Name: Cancer Antigen; Result Unstructured Data: Test Result:16; Test Date: 20240423; Test Name: Core needle biopsy; Result Unstructured Data: Test Result: confirms invasive breast cancer; Test Date: 20250109; Test Name: Microsatellite Instability (MSI); Result Unstructured Data: Test Result: Stable; Test Date: 20250109; Test Name: Eosinophils; Test Result: 10.9%; Comments: (H); Test Date: 2025; Test Name: Eosinophils; Test Result: 0.90%; Comments: (H); Test Date: 202411; Test Name: genetic panel; Test Result: Negative; Comments: negative for standard pathogenic drivers (BRCA1/2 Negative, PALB2 Negative), ruling out genetics; Test Date: 20250109; Test Name: Estimated GFR (eGFR); Result Unstructured Data: Test Result:68; Test Date: 20250109; Test Name: Granulocytes; Result Unstructured Data: Test Result: Unknown results %; Test Date: 20250109; Test Name: Hematocrit; Result Unstructured Data: Test Result: 41.4; Test Date: 20250109; Test Name: Hemoglobin; Result Unstructured Data: Test Result: 13.9; Test Name: Pulse; Result Unstructured Data: Test Result: 75; Test Date: 202403; Test Name: HER2; Test Result: Negative; Test Date: 202403; Test Name: imaging; Result Unstructured Data: Test Result: invasive lobular carcinoma of the right breast; Test Date: 202411; Test Name: "Fingerprint" Evidence; Result Unstructured Data: Test Result: provides the molecular "smoking gun"; Test Date: 202411; Test Name: "Fingerprint" of Vaccine Injury; Result Unstructured Data: Test Result: tumor shows High MYC Expression (85th percentile); Test Date: 20240423; Test Name: CC Cancer Staging; Result Unstructured Data: Test Result: Stage IV (cT2, cNO, pM1, G2, ER+, PR+, HER2-); Test Date: 202411; Test Name: tumor mutational burden; Result Unstructured Data: Test Result:5 mut/MB; Comments: Low; ruling out standard environmental carcinogens; Test Date: 20250109; Test Name: Lymphocytes; Result Unstructured Data: Test Result: 1.55; Test Date: 20250109; Test Name: Lymphocytes; Test Result: 18.8%; Test Date: 202403; Test Name: MRI; Result Unstructured Data: Test Result: Metastatic disease; Test Date: 202403; Test Name: Mammogram; Result Unstructured Data: Test Result: abnormality in the right breast; Test Date: 20240328; Test Name: Screening Mammo w TOMO; Result Unstructured Data: Test Result: spiculated mass in RUQ of Right breast; Test Date: 20250109; Test Name: MCH; Result Unstructured Data: Test Result: 30.8; Test Date: 20250109; Test Name: MCHC; Result Unstructured Data: Test Result:33.6; Test Date: 20250109; Test Name: MCV; Result Unstructured Data: Test Result: 91.8; Test Date: 20250109; Test Name: Mean Platelet Volume; Result Unstructured Data: Test Result: 12; Comments: (H); Test Date: 20250109; Test Name: Monocytes; Result Unstructured Data: Test Result: 5.7; Test Date: 2025; Test Name: Monocytes; Result Unstructured Data: Test Result: 0.47; Test Date: 20250109; Test Name: Neutrophils; Result Unstructured Data: Test Result: 5.21; Test Date: 20250109; Test Name: Neutrophils; Test Result: 63.3%; Test Date: 202403; Test Name: ER; Test Result: Positive; Test Name: SpO2; Result Unstructured Data: Test Result: 98; Test Name: Physical exam; Result Unstructured Data: Test Result: HEENT: Grossly normal; Comments: Mildly red and swollen turbinates. NECK: Without any palpable cervical or supraclavicular lymphadenopathy. LUNGS: Clear to auscultation bilaterally. AXILLAE: Without any palpable adenopathy. BREASTS: Deferred. HEART: Regular rate and rhythm without murmur, gallop or rub. ABDOMEN: Soft, non-tender. No organomegaly or masses. Bowel sounds normoactive. EXTREMITIES: No edema. NEUROLOGIC: Grossly non-focal.; Test Date: 20250109; Test Name: PIK3CA; Result Unstructured Data: Test Result: Pathogenic Variant; Comments: Exon 21p.K111E; Test Date: 20250109; Test Name: Platelet Count; Result Unstructured Data: Test Result: 274; Test Date: 20250109; Test Name: PET; Result Unstructured Data: Test Result: soft tissue density lesion; Test Date: 20240712; Test Name: PET/CT; Result Unstructured Data: Test Result: confirms Stage IV metastasis (bone, liver, lung); Test Date: 202403; Test Name: PR; Test Result: Positive; Test Date: 20250109; Test Name: Protein; Result Unstructured Data: Test Result:8; Comments: (H); Test Date: 20250109; Test Name: Erythrocytes; Result Unstructured Data: Test Result:4.51; Test Date: 20240328; Test Name: RDW CV; Result Unstructured Data: Test Result: 43.0; Test Date: 20250109; Test Name: RDW CV; Result Unstructured Data: Test Result: 12.8; Test Date: 20250109; Test Name: RET; Result Unstructured Data: Test Result: Fusion Not Detected; Test Date: 20250109; Test Name: Leukocytes; Result Unstructured Data: Test Result: 8.2