BRCA1 Gene Mutation and Neoadjuvant Chemotherapy |
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mindy555 
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Joined: Aug 13 2011 Location: Oklahoma Status: Offline Points: 980 |
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 Posted: Nov 07 2011 at 1:07pm |
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In the thread Donna re-posted was this extremely interesting piece re-posted by hhfheidi, March 20, 2010. FWIW from another poster/forum on bc.org; it has generated quite a bit of discussion: Life Extension Magazine has an article this month about two ways to test for circulating cancer cells. The article says that circulating breast cancer cells can be strongly Her2 positive, even if the primary cancer cells are Her3 negative. The Cleveland Clinic named these tests their top innovation or 2009. These circulating cancer cells CAN BE PRESENT WITH NON-METASTATIC TUMORS! This test is a way to give a prognosis and direct treatment to the tumor that could kill you. It isn't the primary tumor that is dangerous. It is the metastatic cells we have to worry about. These ctc (circulating tumor cells) are more predictive of outcome than hormone sensitivity. This test is more reliable and more predictive of response to treatment than radiological studies. In cases where tumors appeared smaller on radiological tests, there actually was an increase in ctc. In some patients where tumors did not appear different radiologicaly after treatment, these patients actually had less ctc in their blood. Measuring ctc can discern whether treatment is effective for individuals early on in the process. Usually, it takes months to determine if treatment is working. Those months can be crucial to survival. This test is also helpful in determining if someone has had a relapse earlier than they might have detected it. In a study, those who tested positive for ctc had "a 269% increased risk of relapse, and300% greater risk of death," compared to the group that tested negative for ctc. There was a "53 month difference between the time of relapse between the group. In a study, scientists found that all of the metastatic cancer cells differed from their primary tumor cells. This test can provide a "genetic fingerprint" of the metastatic cancer cells and direct treatment toward the circulating cells.It can determine what enzymes the cancer cells produce to determine if a chemotherapy agent will be effective at all. This more detailed test is only done in Europe. For assistance in facilitating the advanced circulating tumor cell molecular analysis available at European laboratories, you can contact the International Strategic Cancer Alliance at 610-628-3419. To find labs that do
this ctc assay for number of circulating cells only, call 1-800-208-3444 |
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Dx July 2011 56 yo
Stage I IDC,TN,Grade 3 Grew to Stage IIa- No ev of node involve- BRCA1+ chondroid metaplasia Daughter also BRCA1+ Mass grew on Taxol FEC 6x better BMX 3/19/12 pCR NED BSO 6/2012 |
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mindy555
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Joined: Aug 13 2011 Location: Oklahoma Status: Offline Points: 980 |
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Posted: Nov 07 2011 at 2:25pm |
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I've often wondered if my Mom was also triple negative due to BC @ her young age. Adversely, I was diagnosed a few months after my 56th birthday. Yet she was only 38. I've brought this up to a few doctors. I haven't done the research yet, though don't know how long they've been treating hormone positive receptor cancers with, for lack of a better term.. "the after drugs." Does anyone know?
When I bring up Mom's treatment of a radical mastectomy and radiation the docs say that's the way "it" was treated back then. What is "it"? All breast cancer? Cancer with negative receptors? Looks like I need to do my homework. I will say it never reoccurred in her other breast. I know from the number on my BRCA positive test it originated on the maternal side of my family. My grandfather had Ashkenazi Jewish heritage. Their family came through Ellis Island from Manchester England when he was a young child. His mother migrated from eastern Europe. I have a theory that Mom's BC did eventually metastasize and the doctors never caught it. Her stomach was extremely distended in later years making her look 7 months pregnant- her liver enzymes were way off. A few docs even thought she was a heavy drinker which was quite a joke. Even a glass of wine was rare. She developed acute myeloid leukemia and died 3 weeks after diagnoses in the hospital after being treated w/ IV chemo. |
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Dx July 2011 56 yo
Stage I IDC,TN,Grade 3 Grew to Stage IIa- No ev of node involve- BRCA1+ chondroid metaplasia Daughter also BRCA1+ Mass grew on Taxol FEC 6x better BMX 3/19/12 pCR NED BSO 6/2012 |
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Suze35
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Joined: Sep 20 2010 Status: Offline Points: 101 |
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Posted: Nov 07 2011 at 2:26pm |
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Mindy,
I just read your post about switching over to FEC, I am so glad MDA was on the ball when YOU reported your tumor growth to them. I can't believe your MO didn't do that! A great example of why it is important to be strong advocates for ourselves!! I am one who did have a response to AC (similar to FEC) so I think you have a great shot with this new regimen. Will you be following up with anything else, such as Carbo/Gemzar, or are they going to see how you respond and then decide? I'm sorry this regimen is kicking your butt a little harder, it can be a tough one. I'll be looking for your updates :). Susan
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9/2010 Stg IIIa, AC+T and Carbo
July 2011-Xeloda+Avastin 9/2011 Stg IV-nodes, bones, liver 10/2011-Abraxane/Tig trial - Abx arm 11/2011-progression, Tig/Abraxane 12/2011-Off trial - Eribulin |
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mindy555
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Joined: Aug 13 2011 Location: Oklahoma Status: Offline Points: 980 |
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Posted: Nov 07 2011 at 3:11pm |
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Susan-
So WONDERFUL to see you!  Thanks for the good words! I was hoping you would post soon as I think about you often. To try to answer your question, my MDA MO was rushed, trying to get my ultrasound in before we met. She seemed off her game and we really didn't talk much other than the FEC x 4 or x 6 regimen. She DID mention new drugs on the horizon and clinical trials. I think her head was on the cutbacks in her research dept. So, I don't really know but intend to ask about follow up chemo when I'm there again.. (in about 5 weeks). I have a totally different message into her now to help out one of our fellow members. How have you been? Isn't it weird to see Christmas everywhere you turn this early? It's ever-present through TV ads and the stores with all their Christmas "stuff" on display. I say it starts way too early for my liking. I can't believe "they" didn't ask for my permission first.  |
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Dx July 2011 56 yo
Stage I IDC,TN,Grade 3 Grew to Stage IIa- No ev of node involve- BRCA1+ chondroid metaplasia Daughter also BRCA1+ Mass grew on Taxol FEC 6x better BMX 3/19/12 pCR NED BSO 6/2012 |
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mindy555
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Joined: Aug 13 2011 Location: Oklahoma Status: Offline Points: 980 |
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Posted: Nov 07 2011 at 3:54pm |
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Kind of an over-simplified thought.. but I'll put it out there anyway.
From everything I've read Taxol appears to be more of a "broad-spectrum" chemo which treats a number of different cancers, not just breast cancer. You could compare it to a very good broad spectrum antibiotic which knocks out a large variety of infections. Maybe that's why it's often part of our chemo regimens......?? I told you it was a very simple theory... That's about all I'm capable of at the moment. |
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Dx July 2011 56 yo
Stage I IDC,TN,Grade 3 Grew to Stage IIa- No ev of node involve- BRCA1+ chondroid metaplasia Daughter also BRCA1+ Mass grew on Taxol FEC 6x better BMX 3/19/12 pCR NED BSO 6/2012 |
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Suze35
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Joined: Sep 20 2010 Status: Offline Points: 101 |
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Posted: Nov 08 2011 at 1:26pm |
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Mindy, thanks for thinking of me
 ! I can understand why your MO seemed a bit scattered - that must be hard having to deal with cutbacks, when it seems this awful business is booming. I think I will just believe you are going to have an amazing response to the FEC - you seem to be already! - and nothing more will be needed. FWIW, I know of several women who had a pretty much complete response to AC alone, so it is totally possible  .We actually had 10+ inches of snow here the weekend before last (I'm in the NE), and talk about not ready for Christmas!! I can't believe everything is out this year already, sigh. I'm still plowing through Halloween candy, hah. It is an interesting theory about Taxol - I believe it is one of the older chemos, so I'm not surprised that TNs are starting to show resistance to it. Much like your antibiotic theory! Cancer is certainly smart enough to figure this stuff out, unfortunately. I am really interested in what may be coming down the horizon for women diagnosed in a few years - targeted tumor testing to see what works. I know that the petri dish does not equate to the body, but it just seems like it would be smarter to have a better idea before we start bombing our systems with drugs that probably won't work. I hope you are continuing to feel better - and that your tumor keeps getting softer! Best, Susan
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9/2010 Stg IIIa, AC+T and Carbo
July 2011-Xeloda+Avastin 9/2011 Stg IV-nodes, bones, liver 10/2011-Abraxane/Tig trial - Abx arm 11/2011-progression, Tig/Abraxane 12/2011-Off trial - Eribulin |
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mindy555
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Joined: Aug 13 2011 Location: Oklahoma Status: Offline Points: 980 |
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Posted: Nov 14 2011 at 5:33pm |
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I love your posts Susan.. Thanks so much for your good wishes, dear lady!!
Well, there's not much we can do about Christmas. time marches on so quickly... it'll be here before we know it. I'm grateful that the next chemo treatment is here at home the Monday before Thanksgiving. I'm responsible for feeding the troops. Not only do I cook for my family, but my family of friends who don't relatives close by. It's the "Tradition that can't be Broken." Dear Lord, give me the energy..  You always rally for all of us with your beautiful encouraging words. You're such a special lady with a truly glorious soul and spirit. I feel privileged to have you in my life, Susan. So let's take this thing one day at a time. Thinking about Thanksgiving hurts my brain. lol Much love my friend, Mindy |
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Dx July 2011 56 yo
Stage I IDC,TN,Grade 3 Grew to Stage IIa- No ev of node involve- BRCA1+ chondroid metaplasia Daughter also BRCA1+ Mass grew on Taxol FEC 6x better BMX 3/19/12 pCR NED BSO 6/2012 |
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