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Dlschurz View Drop Down
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    Posted: Jun 20 2016 at 7:27pm
I found a lump in February of this year. A biopsy revealed that the tumor was cancerous. Tumor was removed on May 12, 2016 and sent off for testing. Met with oncologist on last week who related the cancer was tnbc and sampling of 9 lymph nodes were clear. A pet-CT scan was completed today which revealed no evidence of cancer. A follow up with oncologist is this Wednesday. My question is this. It seems the treatment is backwards from what I have been reading. Tumor was removed before any meeting with the oncologist. The lymph nodes and margins are clear. Now the pet-CT scan was clear. The oncologist related chemo was suggested course of action before today's scan. I am struggling with the concept of aggressive treatment when it seems there is no evidence remaining of the cancer. The tumor was 2.2cm. I have read everything I can and only get more confused. Why is chemo suggested vs radiation when the tumor has been removed with clear margins, clear nodes, and clear pet-CT scan. Any guidance before I meet with the oncologist Wednesday is very much appreciated.
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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jun 20 2016 at 9:32pm
Dischurz,

TNBC is more likely to travel through the lymph system and blood.  It is unknown if any cells might have escaped prior to the surgery so that is why chemo is most always recommended.  A clear PET/CT scan is a great diagnostic tool, but it may not tell you if there are any cancerous cells in the body that are not detectable by the scan.  Not to scare you, but I had a small tumor, clear margins, clean MRI, all sentinel nodes clear and ended up with a recurrence.  I thought the same as you did when I first met with my oncologist - why chemo, it didn't make any sense?  Let us know what your oncologist suggests.

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jun 20 2016 at 10:51pm
I found this explanation on scan limitations:

Imaging tests aren’t perfect

Imaging test can often be very helpful, but they have limits. For instance, most of the time, these tests alone can’t show for sure if a change is caused by cancer.

Imaging tests can find large groups of cancer cells, but no imaging test can show a single cancer cell or even a few. In fact, it takes millions of cells to make a tumor big enough to show up on an imaging test. This is why treatment may continue even when cancer cells can no longer be seen on an imaging test. The goal is to get any surviving cancer cells. Even one can grow and, over time, become a tumor that will again be big enough to cause problems and/or show up on an imaging test.

On the other hand, sometimes imaging tests can show something that looks like cancer, but further tests (such as a biopsy) show that it’s not cancer.

http://www.cancer.org/treatment/understandingyourdiagnosis/examsandtestdescriptions/imaging-radiology-tests-for-cancer


DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Kellyless View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Kellyless Quote  Post ReplyReply Direct Link To This Post Posted: Jun 22 2016 at 1:27am
Because radiation is not going to do anything to stop the errant triple negative cancer cells in your body from growing and spreading. You won't have a positive PET scan until you have a growth on you liver, brain, lungs or bones. At that point when it's grown enough to be detectable your prognosis is very poor. It's very fast growing and very aggressive, meaning it's far more likely to spread than other cancers and spread very fast.
I've been on this board for 7 years. Women come here and ask questions, say they cannot imagine that toxic chemo is right for them. We wish them all the luck in the world and plead with them to come back and tell us how they are doing. We only ever see them come back when it's back and it's spread - heartbreaking. There's been a ton of studies, it's a fact - it is Science - TNBC tumors of the size of yours the prognosis without chemo is poor. Unfortunately it's the only real tool we have to beat it. Fortunately we have chemo that works. Double edge sword? I don't think so, I'm grateful for the chemo. And radiation as well, but mostly the chemo.
IDC, 2.2 cm, Stage IIb,lumpectomy 1/30/09 ACx4,Tx4 36 rads
6/1/16 Local recurrence same breast, same spot 1.8cm Carb.4x every 3 wks, Taxol 12x once wk. Dbl Mast. PCR!! Reconstruction fail, NED!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Jun 23 2016 at 8:23pm
Thank you Kelly for the blunt truth, my wife's recent PET/CT technicians said it now picks-up a 4 millimeter lesion, down from 5mm. If it has uptake, they can do further tests, but health insurance may be an obstacle to some. We live in a big city, perhaps PET scan is more accessible here, San Diego County.  
wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 25 2016 at 3:48pm
Update: my wife's oncologist doesn't want her to have PET/CT scan every 3 months due to radioactive toxicity, says every 6 months max at this point.

Her blood counts back to normal now ! after 6-7 months of finishing chemo+radiation.
She walks an hour a day and takes folic acid and B-12 don't know if a factor, fyi.
wife: IDC/Lobular Stage2B 2008 lumpectomy/TAC+rads
TNBC Stage 3A/w/metaplastic/squamous Nov2015 Carboplatin-Gemzar chemo/masectomy Taxolchemo+rads 4-16
PET scan stable 9-2016/ 1-2017
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