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cherylt View Drop Down
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    Posted: Feb 12 2010 at 3:02pm
I just had a lumpectomy and was told I am a stage 1a. I am looking for a med onc right now and was wondering if there is anyone out there in my stage and what your treatment was.  Chemo seems controversial at this stage.  I am going for a second opinion next week.  Thank you for your help!!Tongue
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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: Feb 12 2010 at 6:48pm
Hello and welcome.  Can you tell us a little more about the size of your tumor and grade?  Any nodes?

It's good that you're getting another opinion.  I was stage 1c and chemo was advised.

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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Post Options Post Options   Thanks (0) Thanks(0)   Quote vaboricua67 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 12 2010 at 6:51pm

Hi Cheryl,

You can see my signature line to see we are similar.  I am a stage 1 with stage 3 agressiveness...If you are TN chemo is your only optiion.  If we wre not TN chemo would not even be a consideration.  We would have had only radiation and probably be put on Tamoxifen.  I would not being waiting and going for second opinions.  TN is pretty clear.  We have not other options.  Sorry. 
 
Cheri
 
dx:8/09, age:42, Stage 1, Gr.3, 1.5 cm, lumpectomy, clear margins, neg nodes, chemo a/c finished 11/09, Taxol thru 3/10
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mary58 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 9:07am
I too, am Stage I, grade 2, lumpectomy, no node involvement.  My margins were .1cm, is that an acceptable distance to say that I don't need chemo, only radiation.  Also, because of my age (58) is TN less aggressive or are the doctor's just being less aggressive because of my age.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Kerry OK Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 11:30am

Mary,

My wife's case is almost the same as your situation.  The first onc said rad only, but he went to a local breast conference and told us that the group was split on chemo.  He said that he was staying with rad only,  but we should get a 2nd opinion.  This onc spent 5 min with us, after a 1.5 hour wait and said rad only.  We set the app for the tattoo and called the 1st onc to tell him our decision  (rad only) and the nurse said he researched and M D Anderson says chemo, no matter the  size, so he changed his mind to chemo then rad.  We were so confused, but from this forum an angel contacted my wife with an app at M D Anderson and we went.  We feel very confindent wth our decision and just finished the 2nd round of taxol.  So far so good.  There are  sooo many loving and caring people on here, you are at a very good place. Good luck with your decision.
 
Brad
DX 11/11/09, IDC, <.5cm, 0-2 Nodes, Stage I, Grade 3 TNBC, Lumpectomy 11/27/09, Age 53 Treatment begins 2/5/10, 12 wkly doses Taxol, 4 doses every 2 wks of A C Then 6 wks Rads
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 11:33am
Mary58,

Tell us a little more about your dx.  What was the size of your tumor?  You said your margins were .1cm.  Is that the size of the tumor or the clear margins around the tumor?  Is the onc recommending no chemo? 

I don't believe your age has anything to do with whether you should get chemo or not.  Chemo is the only line of defense against TN.  A second opinion is a good idea to make sure you're getting the best treatment recommendation.


Edited by 123Donna - Feb 13 2010 at 11:35am
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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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mary58 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 11:46am
The size of my tumor was .5 cm, there was a .01 margin clearance around the invasive and the DCIS.  I worry that I listen to too much of what is said on line, but I don't know how much my onc has invested in little old me.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mary58 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 11:49am
Brad - How is your wife doing on the chemo?  Did she ever regret her decision?  I am a bit afraid of the chemo and when he said I didn't need it, that was just what I wanted to hear.  I feel that I am at a crossroads and I need to make the right decision now.  Very restless and anxious about what to do.  I plan to call my radiation doctor on Monday - maybe get a second opinion, but I had to hold up anything.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Kerry OK Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 12:22pm
Hi Mary,
 
This is Kerry, Brad's wife.  As you probably can tell, he is my online reasearcher.  I still am having trouble reading about everything there to find out about TNBC.  When he told me about you, we thought that I may need to send you a note.  I had surgery Nov. 27th and I was told I had 3 months to start chemo or 88 days to do radiation.  So I believe you still have time to look around and not panic yet.  My first onc (whom I really like) said since my tumor was so small just to do rads only even though it was TN.  Jan 18th I went for a 2nd opinion and he used a flip chart and said radiation only.  I was in there maybe 4 minutes.  So we left and and told each other ok radiation it will be.   I then called my first onc's nurse and left a voice message to let her know that we would just do rads only.  We then went to set up our radiation treatments.  Later that evening we got a call back from my nurse and she said --Oh no, Dr said that you must do chemo since it is TN.  He did a research from MD Anderson and it convinced him of that--.   That is when my wonderful husband became TNBC Forum member---and boy are we glad he did.  I fortunately met a wonderful man on here and he led us to MD Anderson within the week.  I saw a super Oncologist there and she totally convinced us that I must have chemo regardless of the size since it was TN.  I just finished my 2nd week of Taxol and so far the only side effect is that I have a very very red face--it also could be from the premeds.  It just looks like I have been snow skiing and spending time at the beach---don't we wish!!
 
Do I think you should consider doing Chemo?  Definitley YES~~ Do I regret choosing Chemo?  Definitely NO~~Do I wish My plan in life would not have included this ?  Most DEFINITELY~~  But I consider myself still young and I want to see my first grandbaby be born in JULY!!   There are many years ahead of us and I think that we should do whatever we can to ward this evil out of our body!!   My theory is that there are many doctors that really do not know much about TNBC and so they assume that radiation only would be ok.   Don't assume--this is your life ---thank goodness I have my wonderful husband in my court to fight my battles with me!! 
 
Please keep us posted or send us a Private Message.  We would be glad to visit with you more.  Just remember whatever you decide to do will be the right decision for you.  Don't look back and just keep on fighting.
 
Praying for the best,
 
Kerry and Brad
DX 11/11/09, IDC, <.5cm, 0-2 Nodes, Stage I, Grade 3 TNBC, Lumpectomy 11/27/09, Age 53 Treatment begins 2/5/10, 12 wkly doses Taxol, 4 doses every 2 wks of A C Then 6 wks Rads
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Mary58 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mary58 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 12:34pm
Kerry - Thank you so much for your reply.  It is what I need to hear.  The only difference in our story is that my onc knows it is triple negative and he went by the cancer guidelines for triple negative and it showed - No Chemo needed.  How can these guidelines be so off or out of date, if it is really
necessary for more complete treatment?  My doc said he would treat me, but he was recommending that I just needed radiation.  I feel like a fool, to say, yeah poison my body and make me sick and make me lose my hair - if there is only a chance that it might help.  If the cancer is confined to the breast don't you think radiation would do the job.  I appreciate your candor and
I just feel at a crossroads as far as which way to go, and yet really scared.
 
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Kerry OK Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 1:18pm
Mary,
 
Kerry wanted to add, one of the biggest drawbacks was the hair loss issue.  She teaches 6th grade science,  and the thought of losing her hair was concerning.  Our angel, on this forum,  sent a wonderful book of women dealing with these same issues.  It seemed to reassure her.  Kerry and her sister purchased a beautiful cranial prosthesis (wig as I call it)  It is sitting in our bedroom, waiting for the day to be used.  So far so good, but like many other days, when that day comes there will be many tears, but we will get through it because of the many friends and family supporting us. 
 
 The school that Kerry teaches,  raised over $3000 in what they called a "Pink Out" at last night basketball games.   They sold T-shirts and donations for the Susan B Colman Foundation.  The players and fans from both schools were in pink.  They recongized the women fighting this monster between games. I can say that there was a standing ovation and I was so proud to see my wife down on the court recieving her carnation.  Kerry's sister and friends are having a city wide Pampered Chef party next week,  with the proceeds going to the TNBC Foundation.  We hope to give back something in return for the support we have recieved.
 
Thanks to all
Brad
DX 11/11/09, IDC, <.5cm, 0-2 Nodes, Stage I, Grade 3 TNBC, Lumpectomy 11/27/09, Age 53 Treatment begins 2/5/10, 12 wkly doses Taxol, 4 doses every 2 wks of A C Then 6 wks Rads
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mary58 Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 1:24pm
I was given a 80-90% cure rate with radiation.  My onc said that having chemo would only increase my percentage by 4-6%.  I quess I don't understand how it can recur if there is no lymph node involvement and it is contained to the breast.  I have questions that maybe no one can answer.
I just wonder if there are any TNBC out there who only received radiation and are still cancer free.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 1:41pm
Mary,

TNBC is thought to have a higher chance of vascular (blood) and lymph travel than other types of bc. 

For what it's worth, here's a story of my friend, who was dx with TNBC Stage 0 (in-situ) about 14 months before me.  She had a bi-mx and had 5 oncs review her case.  2 said definitely chemo, 2 said no chemo and the other one said he was on the fence and could go both ways.  She agonized over the decision and calculated the % with doing chemo and not.  Chemo only decreased the chance of recurrence by a few percentage points also.  She ultimately decided against the chemo.  Now however almost 20 months later, she agonizes over every lump or pain she feels in her body.  Her new onc said he's surprised she didn't do chemo.  She told me she now regrets not doing chemo.  I think there is so much we don't know about tn and the onc/medical community is just learning that it doesn't fit the standard bc treatment scenario.

One question to ask yourself is if you don't do chemo and choose radiation only, will you worry more about recurrence?  Will there be any regrets? 

Can you get a second opinion with an onc associated with a teaching hospital/major university?
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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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 1:44pm
Originally posted by Kerry OK Kerry OK wrote:

 
 The school that Kerry teaches,  raised over $3000 in what they called a "Pink Out" at last night basketball games.   They sold T-shirts and donations for the Susan B Colman Foundation.  The players and fans from both schools were in pink.  They recongized the women fighting this monster between games. I can say that there was a standing ovation and I was so proud to see my wife down on the court recieving her carnation.  Kerry's sister and friends are having a city wide Pampered Chef party next week,  with the proceeds going to the TNBC Foundation.  We hope to give back something in return for the support we have recieved.


Brad,

You and Kerry are truly blessed to have the support of your community, family and friends.  Fundraiser to give back to this community is a great idea!
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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Post Options Post Options   Thanks (0) Thanks(0)   Quote Kerry OK Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 2:07pm
Mary,
 
Kerry' s onc all knew of the TNBC. She felt the same as you, why do the chemo if not that much help?  The onc that stayed with the no chemo was using guidelines from nccn 2008.  That scared me!!!  Surely he should have something more recent.  The trip to Houston convinced us.  Yes, the numbers for cure are low,  with chemo , but the Dr. at M D A was sure that we needed to do the chemo.  From what I learned about TNBC it is aggressive and there is alot of uncertainity on what is best.  Therefore we went the aggressive treatment route.  You will learn what to do, NO one is the same and teatments vary and side effects vary. This is what makes TNBC so difficult.  We were willing to take a chance for a better chance of NO MORE CANCER.  Its tough and you will learn there many tough decisions yet to come. We are just giving you our story. I think you need at least one more opinion maybe a 3rd.  Praying for you because we do know what you are going through. 
 
Brad
DX 11/11/09, IDC, <.5cm, 0-2 Nodes, Stage I, Grade 3 TNBC, Lumpectomy 11/27/09, Age 53 Treatment begins 2/5/10, 12 wkly doses Taxol, 4 doses every 2 wks of A C Then 6 wks Rads
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Post Options Post Options   Thanks (0) Thanks(0)   Quote walk4cure Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 11:50pm
Mary,
In my case my Onc insisted on right masectomy and chemo and never mentioned radiation.  I was told this was not an option for TN.  I have since learned the teatment can go either way depending on your tumor.  Going through chemo was hard,( I worked full time)  but the blessings of being here still today and now a grandmother were worth every treatment.   7 years and cancer free!
Keep strong, and be positive with your decision. 
Mary
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TNBC 3/2003, Rt Mast,16node-neg,Stage I,Grade III, BRCA-I&II neg,Chemo ACTx16,Taxol 6 txs,No rads, Reconstruct5/07, Latissimus Muscle.
12/2010-Lt Mast. ER/PR+ HER2-GradeI,Stage? Path-pending
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Post Options Post Options   Thanks (0) Thanks(0)   Quote walk4cure Quote  Post ReplyReply Direct Link To This Post Posted: Feb 13 2010 at 11:59pm
Brad and Kerry,
I was so proud to hear of the donations raised for the Susan G. Komen Foundation.  This is a wonderful foundation. I have walked in 3 of the 60 mi 3-day walks, and will be walking in 4th in SFO this October.  Keep up the donations.  We all will benefit from the research that this foundation will give us and someday a cure for breast cancer.
 
Mary
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TNBC 3/2003, Rt Mast,16node-neg,Stage I,Grade III, BRCA-I&II neg,Chemo ACTx16,Taxol 6 txs,No rads, Reconstruct5/07, Latissimus Muscle.
12/2010-Lt Mast. ER/PR+ HER2-GradeI,Stage? Path-pending
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Post Options Post Options   Thanks (0) Thanks(0)   Quote outnumbered Quote  Post ReplyReply Direct Link To This Post Posted: Feb 23 2010 at 10:50am

Hi Cheryl, Mary and Kerry, and anyone else this pertains to...

 
Here is my story and I apologize in advance because I tend to be long winded. 
 
6/24/2008 (age 40) I had an excisional biopsy and it was found to be a 1.6 cm DCIS and "multi foci" IDC largest being 2mm. It was found to be TN and it was grade 3.   I had my bilateral nipple sparing mastectomy 8/5/08. One sentinal node was found to be negative.   I also found out I was BRCA 1+.
 
Finally saw my oncologist from Cornell (NY Presbyterian) late August of that year and she said no chemo, however I should get a second opinion at Sloan.  The numbers she gave me regarding risk of recurrance and overall survival seemed ok to me.  When Sloan confirmed this I was happy.  Who wants chemo, after all?
 
Flash forward to February 2009, I discovered this website and all the information regarding TN disease.  I read what was posted here and did my own research as well.  I felt like I had been punched in the gut.  The numbers I was previously given were not applicable to TNBC.  My old oncologist did not know what she did not know.  I went into panic mode.  After much research, in March I went to Boston to see who I felt to be the TN "guru".  He said to me that size does matter even in TNBC.  He did not say this exactly, but I got the feeling it might have been different if it had not been nine months post dx.  Also, had it been a little larger, perhaps 5mm, I might have been given the option to get chemo.  What did result from my consultation in Boston, though, I was told to have my nipples removed because of my BRCA+ status, but that is another story alltogether. 
 
One year later, present day, I am finished with all my surgeries (6 in 2 years).  I see a very TN savy oncologist here in NJ.  She assures me I am cancer free (we do not say cured).  In the back of my mind it still haunts me from time to time.  I am not consumed by fear, but it hits here and there.  Did I do everything I could to destroy this beast?    I mean really, the difference between 2mm and 5mm is sooo tiny...and what the hell is multi foci any way, how many, be specific????  I would have liked to have had the extra insurance. 
 
That all being said, it was not offered, therefore I did all I could.  It is in God's hands, as it always has been anyway.  I have done my footwork.  There are many many many ladies who have not had recurrances.  Its our job to make decisions based on on the information we have, do the necessary footwork, and then go about our life giving back what has been so freely given to us. 
 
I will never give advice, I can only share my own experience and hopefully it can be of some use to someone else. 
 
HUGS!!!!


Edited by outnumbered - Feb 23 2010 at 11:10am
~Sara

DX @ age 40 6/24/08 Stage 1 Grade 3 BRCA1+ 187delAG

BMX (nipple-areola-sparing) 8/5/08

Redo BMX (remove nipple and areola) w/ Lat Flap 7/6/09

BSO 9/3/09

NED since 08/05/2008
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