Tough position need your advice (not medical)
I am really in a very difficult position and could truly use some hope and perspective from people who may have gone through something similar.
My mom was diagnosed on December 9, 2025 with extensive bone metastatic breast cancer. She previously had Stage II breast cancer in 2024.
We did genomic testing and found a PTEN mutation, so since February she has been on Fulvestrant + Truqap. A PET scan in March showed progression, including dural metastases, for which she recently completed radiotherapy. At the time, the oncologists told us the March scan may have been done too early and that we needed to give the treatment more time.
We waited until now, but the new PET scan unfortunately showed:
- increased number and activity of bone lesions,
- new thoracic lymph nodes,
- and possible chest wall recurrence.
During these months, she also went through:
- right femur surgery after a pathological fracture,
- multiple radiation sessions,
- and a focal seizure related to the dural metastases.
Despite all this, she is still functional, interacting, and there are still no liver or lung metastases on the scan.
We are emotionally exhausted and trying to understand what realistic hope still exists from here. We are not willing to pursue traditional IV chemotherapy.
Her subtype is:
- ER positive (low, around 20%)
- PR negative
- HER2 ultralow
Could therapies like Enhertu still be meaningful options in this situation? Have others seen good responses after progression on endocrine + targeted therapy?
I would really appreciate honest but hopeful perspectives right now.