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radiation after TCR and no lymphnodes involved

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Category: TNBC Forums
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URL: http://forum.tnbcfoundation.org/forum_posts.asp?TID=13623
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Topic: radiation after TCR and no lymphnodes involved

Posted By: novemberrose
Subject: radiation after TCR and no lymphnodes involved
Date Posted: Oct 31 2019 at 7:32am

Hello forummembers,

i am a new member from the netherlands, just found this forum today.

I was diagnosed last april with TNBC. It was grade 3, stage 2A. Tumor measurements were 2,8 cm.

I had neoadjuvant chemotherapy (AC and paclitaxel) with a total response to the AC according to the MRI.(paclitaxel which followed had to be stopped early because of neuropathy in my feet).
3 weeks ago I had a lumpectomy in which also a total response was seen, and nothing was found in my lymphnodes.

Since I had a lumpectomy and not a mastectomy, my doctors want me to do 15 sessions of rediation therapy.

I read different things about the neccessity of radiation after a full response and a lumpectomy. It has benifits when there is not a full response, or if there are lympnodes involved. But in my case there is a full response and no nodes involved.

Has anyone been in this situation? what was your decision about radiation?

Replies:

Posted By: Kellyless
Date Posted: Oct 31 2019 at 1:10pm

TNBC is much more likely to recur than hormone positive breast cancer, I'm sure you know that, it's why you did chemo. After FULL treatment, (ie: either mastectomy with clear margins and no lymph nodes, lumpectomy with radiation and no lymph nodes or either of those with lymph nodes involved but removed and radiated) the recurrence they are worried about are distant - elsewhere in the body. With your PCR there's a less likely chance - congratulations!! But it's a lowered chance - not at all a NO chance. TNBC is a breast cancer - it starts in your breast. It's usually grade 3 as yours was - very aggressive, very fast growing. It doesn't have to be big to spread. And seeing it on a mammogram in your breast with all the scarring from surgery? Difficult. I know, I had a rare recurrence 7 years after the first. Same spot. I just....knew. It was not palpable, they couldn't find it with mammogram and ultrasound, but I KNEW. Luckily my Dr. Believes in survivor intuitions I did an MRI - almost 2 cms big, there it was. The point of my story is - why skip radiation on your breast that had cancer?? It lowers the chance of local recurrence - a recurrence that could be very hard to see on scans until... Frankly, until it's too late. You've come so far, think very carefully before you skip a step like that. PCR is no guarantee, stay vigilant.

-------------
IDC, 2.2 cm, Stage IIb,lumpectomy 1/30/09 ACx4,Tx4 36 rads
6/1/16 Local recurrence same breast, same spot 1.8cm Carb.4x every 3 wks, Taxol 12x once wk. Dbl Mast. PCR!! Reconstruction fail, NED!

Posted By: novemberrose
Date Posted: Nov 02 2019 at 12:11pm

Thanks Kelly, your post has helped me get my thoughts straithened. It turnes out that my doctor had some info on recurrence. The checes of recurrence in all forms of BC combined after pcr is 6.9 percent in 10 years, after someone had radiation. The numbers for TNBC are higher, probably around 10 percent.

Not taking radiation multiplies that chance with 3 to 4. So that makes it 30 tot 40%chance of recurrence. And she also said that an new study shows that 40 percent of returning tumors are incurable.

These things combined have made choose to go ahead with the radiation. I had my ct scan and my tattoo-dots yesterday. the circus will start the week after next.

Posted By: strongtogether
Date Posted: Nov 02 2019 at 6:20pm

That seems like a wise decision