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To chemo or not chemo....

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TerriD View Drop Down
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    Posted: Nov 09 2018 at 7:03pm
I am struggling with the decision whether to have chemo or not. Stage 1, 1cm, lumpectomy, not in lymphnodes and negative pathology report. I have met with both radiology and medical oncology and they feel I should have both but not sure. Had a friend that had radiation only after lumpectomy and she's 10 years clean and free. Having TNBC, I'm not sure what to do.
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Meadow View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Meadow Quote  Post ReplyReply Direct Link To This Post Posted: Nov 10 2018 at 12:36am
I don't know what kind of breast cancer your friend had, but TNBC is different from other types of breast cancer. You really have to think of the different types as totally different diseases. TNBC is more aggressive than most other types, and I've heard it can spread through blood vessels as well as lymph nodes. Also, for others types of breast cancer there are targeted treatments like Herceptin and Tamoxifen. There is no targeted treatment for TNBC. Chemo regimens are based on years of study and resulting survival statistics and type of cancer is taken into account. Ask your doc to show you survival statistics for those with your profile w ho do and don't do the chemo regimen that is recommended for you. For my profile (TNBC, age 44, Stage I, no lymph node involvement, negative pathology report, in good health otherwise), the chance of metastasis without chemo was something like 22% and with chemo it was something like 12%. I wanted that extra 10% chance of a cure. I'm 9 years out now. I'll never know if chemo made the difference, but I have no regrets.

I can't speak to radiation. I had mastectomy (due to having a BRCA mutation), and there were clean margins between the tumor and my chest wall, so radiation would not have increased my chances of survival. So it was not recommended.

Take care and keep posting if you have questions or need support.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote rstar Quote  Post ReplyReply Direct Link To This Post Posted: Nov 10 2018 at 4:21am
Hi Terri,

There are chemo regimens like CMF and TC that do not include Adriamycin and its (small) potential heart damage. Keep in mind that these regimens are considered lighter than the standard AC-T and most likely are less effective, but better than having no chemo at all if that's the route u decide to take. I personally would go with the standard regimen because Triple Negative is not a disease to mess with.

Edited by rstar - Nov 10 2018 at 12:22pm
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gordon15 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote gordon15 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 10 2018 at 7:25pm
Get a second opinion before you do anything. It takes 7 years for breast cancer to show up, not to minimize that it is TNBC. You have a month to decide, based on a second or even third opinion.

Edited by gordon15 - Nov 10 2018 at 7:42pm
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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TerriD View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote TerriD Quote  Post ReplyReply Direct Link To This Post Posted: Dec 01 2018 at 3:30pm
Iwent for a second opinion and it was confirmed that I definately need to do chemo.  Now I have a week to decide on whether I want "dd-ACT" for 4 months (8 doses) or TC for 3 months (4 doses).  The doctor recommends dd ACT saying there is a 2% advantange over the TC statistically.  I would like to only have to do half the amount of doses however with the TC.  Anyone have any feedback, it would be 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: Dec 02 2018 at 11:38pm
Hi Terri,

I don't have the answer to help you out.  What do you want to do?  Do you want the extra 2% advantage or go with the shorter dose cycle?  I can tell you my story.  My tumor was 1.5 cm, stage 1 and after my bilateral mastectomy I had TC chemo.  What we didn't know at the time was that some cells had escaped the tumor prior to surgery and ended up in some regional nodes.  They were too few to be detected at the time by the MRI.  About 13 months after finishing chemo, a PET scan showed the recurrence to the internal mammary nodes.  I've always wondered if I had the AC/T chemo, if it would have wiped out the cancer in the regional nodes.  I do have some regrets, but at the time, all the nodes appeared to be clear, including the sentinel nodes. 

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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Meadow View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Meadow Quote  Post ReplyReply Direct Link To This Post Posted: Dec 03 2018 at 6:35pm
TerriD, I was given exactly the options you were given. I was Stage I with a 1 cm tumor and clear lymph nodes. I chose to go with dd-ACT because I wanted that extra 2% chance of a cure.
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