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JoanE View Drop Down
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    Posted: Jan 15 2021 at 7:12pm
Hi all,

I was diagnosed with metastatic TNBC in June, although there was some disagreement with the staging and some doctors saw the cancer as locally advanced. The disagreement has to do with whether the cancer cells that lit up during the PET Scan in the mammary glands behind the chest wall are considered local and whether the cancer was in the sternum or pushing on it. There was a 2.5 cm. tumour in my left breast and one lymph node in my left arm pit was cancerous. That's by way of background.

I have had a pCR from a combination of Tecentriq (immunotherapy) and nab-Paclitaxol and my doctors are now debating whether I should undergo radiation. They seem agreed that surgery is not called for. I haven't been able to find any studies on the use of radiation following immunotherapy or concurrent with it. My doctors can't find any either. They took my case to a "conference" of 20 cancer doctors and they split down the middle as to whether radiation should be done. Those opposed was concerned about lung damage. There are several references in online reports to this being an understudied area since Tecentriq was relatively recently approved as a treatment for TNBC.

I'm wondering if anyone has had any experience with immunotherapy and radiation or any ideas of where any information might be found. My oncologist has consulted with Dana Farber docs and Peter Schmid who led the Tecentriq/Paclitaxol study.

Thanks for considering this.   
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123Donna View Drop Down
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Post Options Post Options   Thanks (1) Thanks(1)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jan 16 2021 at 12:18pm
Hi JoanE,

My recurrence was to the internal mammary nodes behind the sternum.  They lit up on a PET scan but had to have an MRI to identify exactly the recurrence was located.  A fine needle biopsy confirmed the recurrence.  I had chemo and then radiation.  Like you I was concerned about the damage.  I had a type of radiation called IMRT that was supposed to be more pin-pointed and reduce the chance of damage to other areas.  There are other types of radiation that are newer (proton beam radiation), but some insurance companies may not cover it.

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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