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% of cancer left after chemo/surgery
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grma View Drop Down
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    Posted: Dec 28 2010 at 4:46pm

After chemo and surgery, my pathology showed that in the tissue removed, I had 1% cancer in breast and 5 of 31 nodes with cancer. .43cm being the largest.  I will have radiation soon.  My onc. says that I qualify for a study to give more chemo after radiation.  However, chemo is not proven to prevent reoccurrence.  Has anyone any experience with this?

grma Mary Ann
dx5/26/10 5cm/5nod/stg3gr.2 neadjuv Taxol 12/FEC 4
mast.Dec.2010/6wks.rad 3-11
NED NO RECON
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123Donna View Drop Down
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Points: 13510 		Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Dec 28 2010 at 4:54pm
Mary Ann,

Please read Page 19 of this link (and page 70).  If I'm reading it correctly, adjuvant chemotherapy is recommended.
 
http://www.nccn.com/images/patient-guidelines/pdf/breast.pdf
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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dmwolf View Drop Down
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Points: 3619 		Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Dec 28 2010 at 5:27pm
Mary Ann, in your shoes I would definitely try something.  Having positive nodes after chemo puts you at high risk of recurrence.   Since you already had taxol and an anthracyline (the 'E' in FEC), I'd go for a class of drugs other than these.  Maybe a platinum drug, like carboplatin, possibly with gemzar and a PARPi.  Do you know whether you are BRCA+?
Good luck, and know that we are here to help.
love,
d
DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.
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grma View Drop Down
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Points: 168 		Post Options Post Options   Thanks (0) Thanks(0)   Quote grma Quote  Post ReplyReply Direct Link To This Post Posted: Dec 28 2010 at 5:33pm
123Donna- I've already had chemo prior to my mastectomy. I think from reading those pgs. the guidelines are preoperative ?
In other words, I had neoadjuvant chemo which did shrink my breast tumor.  What I had concern about is what they found after chemo and surgery in the tissue removed.
Any helpful places to find that info?
grma  Mary Ann
dx5/26/10 5cm/5nod/stg3gr.2 neadjuv Taxol 12/FEC 4
mast.Dec.2010/6wks.rad 3-11
NED NO RECON
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grma View Drop Down
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Points: 168 		Post Options Post Options   Thanks (0) Thanks(0)   Quote grma Quote  Post ReplyReply Direct Link To This Post Posted: Dec 28 2010 at 5:46pm
dmwolf- That option of the platinum etc. was not offered to me.  I am at MD Anderson and I guess that I will have to push for those options.  I was offered a study with ixabepilone.  However, it is randomized, so I don't know if I will even get it.  This will be given after my radiation.
In checking the parpi studies, it looks like you have to be stage IV.  Maybe I'm just not looking in the right places.  Any guidance there?
thanks- grma Mary Ann
dx5/26/10 5cm/5nod/stg3gr.2 neadjuv Taxol 12/FEC 4
mast.Dec.2010/6wks.rad 3-11
NED NO RECON
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dmwolf View Drop Down
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Points: 3619 		Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Dec 28 2010 at 5:54pm
I think the right page to look at in that booklet is page 25, but the information is a little bizarre.  They imply that the only important measure is whether the tumor shrinks during neoadjuvant chemo.  It suggests additional chemo only if the tumor does not shrink.  Mary Ann's situation is that all tumors shrank, but she is left with some cancer in her lymph nodes.  According to this chart, she would be 'done'.  But the research I've seen (e.g. ISPY1) indicates that having tumor left in lymph nodes puts one in a very high risk category, therefore calling for some type of additional treatment.    Though the fact that you have grade II rather than grade III cancer is hopeful.  This may mean that even though the chemo didn't zap it all out of the nodes, it isn't that aggressive and might not have traveled elsewhere.  Still, as i said before in your shoes I would at least look into what trials are available.  Let us know and we can help you weigh your options.
Best,
d
DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.
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123Donna View Drop Down
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Points: 13510 		Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Dec 28 2010 at 7:22pm
Mary Ann,

You might want to ask about the Parpi studies.  The one I'm in is available to locally advanced or metastatic bc and open for expanded access.  My recurrence is a regional recurrence and I was able to get into the trial.  You might want to ask if there are any clinical studies (parpi or not) that you would qualify for. 

Mainy posted this in another thread about clinical trials for tnbc.

15 trials coming available from September through today for Triple Negative   http://clinicaltrials.gov/ct2/results?term=triple+negative+breast+cancer&recr=&rslt=&type=&cond=&intr=&outc=&lead=&spons=&id=&state1=&cntry1=&state2=&cntry2=&state3=&cntry3=&locn=&gndr=&rcv_s=09%2F01%2F2010&rcv_e=12%2F16%2F2010&lup_s=&lup_e=
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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