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Neoadjuvant chem success

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Asovey View Drop Down
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    Posted: Dec 09 2017 at 1:02pm
Right now the plan I have is for neoadjuvant chemo.  My doctor said some patients have a complete success with that and when they go for surgery, the cancer is gone.  I am stage III, with a couple lymph nodes involved.  Has anyone had this response?  Sure sounds good to me!
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ClistaR View Drop Down
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Post Options Post Options   Thanks (1) Thanks(1)   Quote ClistaR Quote  Post ReplyReply Direct Link To This Post Posted: Jan 03 2018 at 12:44am
I've had more of a response from the taxol than the A/C treatment, it would seem. Had an ultrasound before starting the taxol, A/C was first, and it showed no change in the size but that isn't the definitive tool to judge a response. 

My surgery will be in about a month so I can let you know once the pathology comes back.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Kellyless Quote  Post ReplyReply Direct Link To This Post Posted: Jan 03 2018 at 11:23am
I had a complete response to chemo. Scans are NOT an accurate way to measure response to chemo, they can show growth of tumors which is important (it's rare, but can happen), and usually will show shrinkage. A "dead" tumor still usually shows up. It leaves a "tumor bed", kind of like scar tissue I guess. It shows up on the scans and you won't know until after surgery what it is. It happened to me and I just wasn't prepared for it. I got very sick in chemo this time (Carboplatin really hated me). At the end of my scheduled treatment when there still showed the remainder of it on scans, it was devastating to me. My MD Anderson oncologist suggested I do a course of CMF.... I fell apart. My UT Dr. said what I was feeling - you've done all you can handle, there's a chance it's actually all dead already, have your surgery. So I did, 100% thinking I'd do 6 more months of chemo afterwards. I went in for my post surgical appointment, when she said, "I have the best news, there was no cancer left alive in your pathology. You had a complete response to chemo!" For the first time ever in either of my cancer bouts I burst into tears. Best.News.Ever.
All that said, its not the norm. Most women have some cancer left, but still are cured after surgery and never have a recurrence. I wasn't done with treatment - I had surgical complications leading to 2 more surgeries and 8 1/2 months of wound care. Months of physical therapy. Every cancer journey is different, usually with terrible lows and Wonderful highs...I've No idea what my future holds but for now I am awash in gratitude, I feel very lucky to be here and I'm doing my best to find the joy in everything because of it.
IDC, 2.2 cm, Stage IIb,lumpectomy 1/30/09 ACx4,Tx4 36 rads
6/1/17 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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Asovey View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Asovey Quote  Post ReplyReply Direct Link To This Post Posted: Jan 03 2018 at 1:26pm
Your response gave me goosebumps!  Thanks for all the great information.  I start chemo on Friday.  I hope to get a complete response too!

Ann
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Jan 04 2018 at 8:11pm
My wife had neoadjuvant chemo, "Carboplatin-Gemzar", it killed 75% of her tumor, and all the cancer in 3 lymph nodes. One node was still enlarged but subsequent PET scans showed it getting smaller,(tissue trauma) and it went away, that's why, if you can have a PET scan, it really tell a lot.

Her tumor -cancer turned out to be "Metaplastic-squamous", a rare (1%) of TNBC, it basically, crossed over into skin cancer cell properties, so after mascectomy, they gave her Taxol chem and radiation to "throw everything at it" in their toolbag. The tumor was about 4cm, then 1.25 cm was left after neoadjuvant chemo.

She had T"A"C chemo in 2008, so the "A" which is Adriamycin, she can not have any more because there is a lifetime limit on how much a patient can have, so that's why they gave her Carboplatin-Gemzar before surgery.

She was Stage 3C, but after the chemo before surgery killed the cancer in her lymph nodes ( you get a pathology report that says "necrosis", that's the best word you can see, meaning dead tissue) they down-graded her Stage to 3A.

My wife has an aggressive typ, so you may not need the same chemo,  but she had Taxol chemo and radiation after surgery, it was basically, all of 2016 for her therapies, but it seems to have gone by fast.
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 Kellyless Quote  Post ReplyReply Direct Link To This Post Posted: Jan 06 2018 at 2:13am
In hindsight it really bugs me they don't do a PET or an MRI with contrast to see if the tumor is gone or not. That's a great question to ask. I bet the answer is insurance won't pay, but worth asking.
IDC, 2.2 cm, Stage IIb,lumpectomy 1/30/09 ACx4,Tx4 36 rads
6/1/17 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 Faith18 Quote  Post ReplyReply Direct Link To This Post Posted: Jan 17 2018 at 9:26pm
I had double mastectomy last Dec. 18 right after I was diagnosed with breast cancer.  I had Stage 2A 3.5 cm TN none on lymph nodes BRCA negative.  I didn't know that you can have chemo before surgery and my surgeon didn't even mention it to me.  I know that it's too late now but this question still haunts me.  Did I miss anything by not having the neoadjuvant treatment?  Would that have been a better treatment for me?  Did anyone skip the neoadjuvant and went straight to surgery like me?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lisa s Quote  Post ReplyReply Direct Link To This Post Posted: Jan 17 2018 at 11:15pm
I would not second guess. It is what it is. I know people who did chemo before or chemo after. The important thing is that they got the cancer out regardless of if it was before or after.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Kellyless Quote  Post ReplyReply Direct Link To This Post Posted: Jan 18 2018 at 9:25am
9 years ago when I found my lump they botched my biopsy. Instead of attempting another biopsy, the surgeon said we should just remove the lump. I was shocked to wake up with a sizeable chunk of my breast gone, along with ALL of my lymph nodes (29), and further stunned to learn it was TNBC, off the charts aggressive, etc. But after chemo and radiation it was gone - cured. I did not however get the option of mastectomy - I didn't have time before I had to start chemo, and afterwards all doctors said there was no medical reason. They were right, I was cured... Until a recurrence in in 2015.
My surgeon was wrong to do a lumpectomy without diagnosis. Your surgeon was wrong to not give you all the options. But many women have surgery first and it is just fine! A recurrence after 2 years or longer in the breast without the gene is exceedingly rare. I was like a lil medical marvel with mine.
DO seek out a second opinion on everything going forward! Especially see a new surgeon, you deserve a better one.
IDC, 2.2 cm, Stage IIb,lumpectomy 1/30/09 ACx4,Tx4 36 rads
6/1/17 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: Jan 18 2018 at 5:52pm
Faith: From what I know, since my wife had chemo BEFORE surgery, she had a tumor over 4.5cm and 3-4 lymph nodes enlarged and "probable "for cancer, (they were right)

So, it's possible, especially since no lymph nodes were abnormal, they didn't think chemo BEFORE surgery was  warranted.

Our experience is that they want to give chemo BEFORE surgery (my wife had single mastectomy) to shrink the tumor and kill what is obvious cancer in the lymph nodes, which my wife had and they were right. The chemo before surgery reduced the tumor by about 75% and killed the cancer in her lymph nodes.

I think if you trust your oncologist then he/she is not going to recommend chemo before surgery(adjuvent chemo) if the final benefit out-weighs the risk, since there is always a risk to having chemo.


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 ImasurvivorJa Quote  Post ReplyReply Direct Link To This Post Posted: Feb 05 2018 at 2:38am
Hi Everyone

Faith18...I was told that neoadjuvant is for patients with more advance breast cancer. I had stage 2b, 1 node positive and I was told it was my choice which way I wanted to go but neoadjuvant was recommended.
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