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Aggressive enough?

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lizziealberta View Drop Down
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    Posted: Jun 30 2014 at 4:50pm
In 09, I was diagnosed with ER+ node neg  BC. Had C/T, rads, AI, and currently NED for the ER+ cancer. In April during a regular MRI, a lymph node lit up in my arm pit. It's TNBC. A case review at Moffitt Cancer Center found the cancer in 09 was misdiadnosed by the pathologist. It was an ER core with a TNBC shell. If I had A/C/T in 09, we might not be here but my oncologist wanted to save me the potential for heart issues since I am an athlete.
Fast forward 4.5 years and I feel like he is again being too conservative, reccommending 4 rounds A/C (just finished) then abraxane. I have been reading the ISPY study and feel carbo/taxol and potentially also avastin are called for. The consulting oncologist at Moffitt agrees with me. I am not sold on avastin but am sold on the carbo.
I am no shrinking violet. I know how to handle my oncologist but the issue is: what is the right choice? Do I try for a third opinion to break the stalemate? What If I push hard and choose wrong? I am made of steel but I assure you, I cannot do this a third time. Help
ER+ misdiagnosed 09, was ER+/TNBC,lumpectomy, C/T, rads, AI. TNBC in node 4/14, in neoadjuvant A/C then carbo/gemzar, complete path response. double mastectomy.
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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 30 2014 at 4:59pm
Just my two cents, I'd add the Carboplatin, but skip the Avastin.  Here's a link to some studies showing Carbo increases pcr, but not so much good news on Avastin and too toxic.

http://forum.tnbcfoundation.org/adding-carboplatin-increases-pcr_topic11688.html

You can always get a third opinion if it will make you feel better.  I got 3 for my radiation treatment with my recurrence.  Sometimes we're trying to make the best decision, not really knowing how our tumor's will respond. 

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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lizziealberta View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote lizziealberta Quote  Post ReplyReply Direct Link To This Post Posted: Jun 30 2014 at 5:27pm
I have a PET scheduled for Monday to see how I have responded to the AC. But from my standpoint, even if it looks clean as a whistle, I would prefer to do the carbo.
Thanks for the heads up on avastin
ER+ misdiagnosed 09, was ER+/TNBC,lumpectomy, C/T, rads, AI. TNBC in node 4/14, in neoadjuvant A/C then carbo/gemzar, complete path response. double mastectomy.
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