Mastectomy before rads?
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Topic: Mastectomy before rads?
Posted By: islandmama
Subject: Mastectomy before rads?
Date Posted: Jun 14 2014 at 10:33pm
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I had a lumpectomy 3 weeks ago for a 4.7cm tumor. Nodes were neg except <200 cells in one node. It is still classified as negative on my path report as only positive on immunostain. I see the MO on June 17 and RO on June 25. I think I want a bilateral mastectomy now that I know I am TN. Just curious if I could do this in between chemo and rads? I know chemo needs to be started within 3 months of surgery but what is the window to start rads after initial surgery? Any stats to support bilateral mastectomy to reduce local recurrence? I am 35. |
Replies:
Posted By: mainsailset
Date Posted: Jun 14 2014 at 11:18pm
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I was told that the optimum time window for starting radiation is 6 weeks after surgery. In my case that was 6 weeks after a Bilateral. I believe there are stats out there that show there is minimal difference in survival rate between lumpectomy and mast however I seem to remember that there were some questions on how the stats were formatted. Here's a link to a discussion from last summer, lots of excellent comments http://forum.tnbcfoundation.org/lumpectomy-or-mastectomy_topic11462.html" rel="nofollow - http://forum.tnbcfoundation.org/lumpectomy-or-mastectomy_topic11462.html ------------- dx 7/08 TN 14x6.5x5.5 cm tumor 3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear |
Posted By: islandmama
Date Posted: Jun 14 2014 at 11:32pm
| Wow 6 weeks?! How is that possible if I have to do chemo first? That in itself will take 4-6 months. |
Posted By: mainsailset
Date Posted: Jun 15 2014 at 8:45am
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Chemo first, surgery 6 weeks after completion, radiation starting 6 weeks after surgery. I'm not counting the chemo time. ------------- dx 7/08 TN 14x6.5x5.5 cm tumor 3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear |
Posted By: Lillie
Date Posted: Jun 15 2014 at 3:50pm
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Dear Islandmama, In your first post you stated that chemo should begin within 3 months after surgery. Actually for best results it is believed that chemo should start no more than 30 days after surgery. This is not always possible, but there is an article on this site about this very subject. The article states that no more thank 30 days after surgery is good. Best of luck with everything. God Bless, Lillie ------------- Dx 6/06 age 65,IDC-TNBC Stage IIb,Gr3,2cm,BRCA- 6/06 L/Mast/w/SNB,1of3 Nodes+ 6/06 Axl. 9 nodes- 8/8 thru 11/15 Chemo (Clin-Trial) DD A/Cx4 -- DD taxol+gemzar x4 No Rads. No RECON - 11/2018-12 yrs NED |
Posted By: Lillie
Date Posted: Jun 15 2014 at 3:57pm
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Dear Islandmama, The article that I am referring to is "Prompt chemotherapy improves outcome." You can read it on the main TNBC site page. Thanks, Lillie ------------- Dx 6/06 age 65,IDC-TNBC Stage IIb,Gr3,2cm,BRCA- 6/06 L/Mast/w/SNB,1of3 Nodes+ 6/06 Axl. 9 nodes- 8/8 thru 11/15 Chemo (Clin-Trial) DD A/Cx4 -- DD taxol+gemzar x4 No Rads. No RECON - 11/2018-12 yrs NED |
Posted By: mainsailset
Date Posted: Jun 15 2014 at 4:43pm
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Perhaps now would be a good time to ask the doctors if you can do the chemo first, then your bm then the radiation. Following up on Lillie's post it does seem the best approach to get going sooner rather than later on the chemo. You've already waited 3 weeks, another month seems peculiar. ------------- dx 7/08 TN 14x6.5x5.5 cm tumor 3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear |
Posted By: islandmama
Date Posted: Jun 15 2014 at 10:11pm
| I also read that article about starting chemo within 30 days. This Wednesday will be 28 days post op. I see the oncologist on post op day 27. I doubt I will get chemo within 3 days of that appointment. This was the first available appointment. Fingers crossed that it will be soon. |
Posted By: mainsailset
Date Posted: Jun 15 2014 at 11:05pm
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When I was going through the maze of testing and scheduling I had my sister by my side who said to the doctor in a very big booming voice, 'just what does it take for you to order the chemo for my sister?' The doctor sat a little straighter, ordered up surgery for me to get a port and within 2 days I was back sitting in a recliner getting my first infusion. Sometimes, it's ok to use your loud voice... ------------- dx 7/08 TN 14x6.5x5.5 cm tumor 3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear |
Posted By: 123Donna
Date Posted: Jun 15 2014 at 11:13pm
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This is another thread talking about the optimal start for chemo: http://forum.tnbcfoundation.org/dont-delay-chemo_topic11759.html" rel="nofollow - http://forum.tnbcfoundation.org/dont-delay-chemo_topic11759.html ------------- 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 |
Posted By: MLindaG
Date Posted: Jun 16 2014 at 9:52pm
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I'm surprised they did the lumpectomy before chemo with that size tumor....often they do chemo first. That being said.....It doesn't hurt to take a fit on the phone either.....I was told 6/11/12 that I had TNBC and they said the surgical oncologist couldn't see me until 7/20/12......After looking up what TNBC meant I called them back and had a fit on the phone....I saw her the day after she got back from her vacation.......they fit me in....6/29/12...did all the required testing in the mean time PET scan/Muga/blood work etc...saw the Oncologist 7/2.....port put in 7/5.....chemo started 7/9/12......... Give them he$$!! ------------- Dx TNBC 6/12; age 59; Stage 3, Grade 3; 3.5 cm, 3/10 nodes + chest wall nodes; A/C x4, T x 12 completed 12/12 with PCR, 2/13/13 lump; IMRT Rads x 33 completed 5/22/13 BRCA 1 negative. |
Posted By: Lillie
Date Posted: Jun 17 2014 at 9:23am
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I could be wrong! But I think there are lots of surgeons who are not educated about triple negative cancer. Of course that goes for oncologists also. We really have to be advocates and ask questions and speak up for ourselves. The problem sometimes is that the patients isn't educated about triple negative and sometimes all of this combined can lead to a less than desired treatment. I've seen it several times while volunteering at the oncology clinic over the past five years. All of us need someone with a BOOMING voice to keep the doctors in tow. Just my 2 cents worth. God Bless, Lillie ------------- Dx 6/06 age 65,IDC-TNBC Stage IIb,Gr3,2cm,BRCA- 6/06 L/Mast/w/SNB,1of3 Nodes+ 6/06 Axl. 9 nodes- 8/8 thru 11/15 Chemo (Clin-Trial) DD A/Cx4 -- DD taxol+gemzar x4 No Rads. No RECON - 11/2018-12 yrs NED |
Posted By: SANDRATRIPLENEG
Date Posted: Jun 25 2014 at 12:12pm
Hi, I had radiation after my surgery. You may want to read this topic under TNBC Research within this organization. It is from March, 2014. http://www.tnbcfoundation.org/tnbcnews_postmastectomy.htm ------------- DX Dec '12, IDC, Grade 3, Stage 3N, 6.5 cm, Left breast, neoadjuvant A/c and Taxol, complete mast in Aug 2013. Complete response to chemo! Radiation, 28 treatments. MASSEY CANCER CENTER, VA |
Posted By: SANDRATRIPLENEG
Date Posted: Jun 25 2014 at 12:14pm
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My treatment plan was the same as Mainsail ------------- DX Dec '12, IDC, Grade 3, Stage 3N, 6.5 cm, Left breast, neoadjuvant A/c and Taxol, complete mast in Aug 2013. Complete response to chemo! Radiation, 28 treatments. MASSEY CANCER CENTER, VA |
Posted By: SagePatientAdvocates
Date Posted: Jun 26 2014 at 1:09am
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Dear islandmama, welcome to our TNBC Foundation family and thank you for sharing your story with us. have you been tested for the BRCA mutation? Did your oncologist speak to you at all about neoadjuvant chemotherapy? Are you seeing a physician at a NCCN or NCI facility? I know your time is critical but if the answers to any of the questions above are no, I feel you should consider getting a second opinion from a top cancer center. I am sending you my contact info in case you would like to talk. I am not a medical professional and will not give you medical advice but as a patient advocate, working as a volunteer, I have some good relationships with some TNBC knowledgeable oncologists. good luck to you. warmly, Steve ------------- I am a BRCA1+ grandson, son and father of women affected by breast/oc-my daughter inherited mutation from me, and at 36, was dx 2004 TNBC I am a volunteer patient advocate with SAGE Patient Advocates |