Er+ oligomet breast cancer. Have been 5aking ribocyclib for 14 months. Because of my low neutrophils the dose was...

I want to make sure I'm giving you the most helpful educational information. Let me clarify what I'm seeing in your message — it looks like it got cut off at "10-13" (days, I assume?).

Before I provide a detailed response, could you confirm:

1. Are you taking 10-13 day breaks instead of the standard 7-day off-cycle?
2. Do you have your latest CA 15-3 marker results? (You mentioned 39.8 in your first message — is that still current?)
3. When was your last CT scan, and was it completely clear?

These details will help me give you the most accurate educational interpretation of your situation.

In the meantime, here's what I can tell you based on what you've shared:

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What We Know About Ribociclib & Neutropenia

According to NCCN Guidelines for Metastatic Breast Cancer, ribociclib (a CDK4/6 inhibitor) is a preferred therapy for ER-positive metastatic disease when combined with endocrine therapy. However, neutropenia (low neutrophil counts) is a known and sometimes dose-limiting side effect.

Your pattern suggests:

• Your bone marrow is particularly sensitive to ribociclib
• Even at the minimum approved dose (200mg), you're experiencing significant neutropenia
• You need extended recovery time between cycles

This is clinically important because it raises questions about:

• Whether your current dose is providing adequate therapeutic benefit
• Whether an alternative CDK4/6 inhibitor might be better tolerated
• Whether your treatment plan needs adjustment

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Please provide those clarifications above, and I'll give you a complete analysis with specific questions to ask your oncologist.

This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.