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Residual disease following neoadjuvant chemo

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: Apr 29 2013 at 11:14pm
CJWatson,

Yes, would be glad to try to be your guardian angel #2.
Your Guardian Angel #1 has been watching over you......helping you ask good questions and make
     good decisions and will continue to help you.

Obviously, the most important thing now is to get additional information (with consideration
from an expert TNBC at a NCCN or NCI center and/or radiation oncology consult) for your plan.

Then, some thoughts........not advice.......on your BRCA testing and Vitamin D3 status.
        If your insurance covers a certified genetics counselor's consult, it might be well to consider.
It does sound like your family history would make you low risk......but others have been surprised
before .......and the certified genetics counselor would be the best one to assess your risk and
assess the need for testing. How fortunate that you know your family history back to the 1800's.
       Believe it or not.....some members from other states with a lot of sunshine have had low
vitamin D3 levels (not sure whether they were supplementing Vit D3 or not). Since you have been
in Florida for some time and have been supplementing Vitamin D3, again, it would seem likely that
you would have a good level....... a simple Vitamin D3 test added to your next blood tests would
confirm your actual D3 status.


With caring and good thoughts,
Grateful for today...........Judy    

Edited by Grateful for today - Apr 30 2013 at 12:03am
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CJWatson Quote  Post ReplyReply Direct Link To This Post Posted: May 09 2013 at 12:40pm
Thank you so much, Judy.  You are definitely Guardian Angel #2.
 
Went to see my new radiation oncologist this week and came out of our meeting very optimistic.  I have really lucked-out with this top-notch doctor.  I will be starting rads as soon as they can get rid of the seroma left over from the surgery. 
64 at DX
10/5/2012, IDC, 2 lumps total 5cm, Stage IIIa, Grade 3, 1 node positive, ER-/PR- HER2
10/16/2012 Chemo: AC x 4
04/08/2013 Lumpectomy- 3mm residual, clear margins, SNB clear
6/10/13 rads
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Carolyn27 Quote  Post ReplyReply Direct Link To This Post Posted: May 15 2013 at 11:56am
I had residual disease in my breast mass and in 1 lymph node. I plan to take part in the clinical trial using PARP inhibitor and Sisplatin as soon as I finish my radiation. I will be going to through UCLA out here in California. Any others considering this trial??
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: May 15 2013 at 12:38pm
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 Carolyn27 Quote  Post ReplyReply Direct Link To This Post Posted: May 15 2013 at 6:20pm
I had residual disease left in 1 lymph node and in my breast mass after 6 rounds of T/C. At my mastectomy they didn't think there was any disease left in the node so they only took 4. Upon final pathology we found there was still remaining disease in the lymph node however small. I decided to go back in 3 weeks later to have a level 1 and 2 axillary dissection done. 
I've just signed up to do the clinical trial using the Sisplatin and PARP inhibitor. I will do this after I do my radiation. Any others interested or have info on this clinical trial??

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Post Options Post Options   Thanks (0) Thanks(0)   Quote debB Quote  Post ReplyReply Direct Link To This Post Posted: May 15 2013 at 8:13pm
Carolyn,

I did this trial. Finished infusion end of May 2012 and took my last oral PARP the day after Thanksgiving. Sounds like you lucked out because two weeks ago they told me there were only a few spots left! If you have your paperwork in I think you should be good though. They won't randomize you until you are ready to start though. Let me know what questions you have and I will do my best to answer them!

Deb
Dx 4/29/11, 46 yrs old, 3.9 cm tumor, Stg 2 Grade 3 chemo 4 rounds DD AC, 12 weekly taxol, finish. Lumpectomy, 2mm residual tumor. 37 rounds rads completed. Cisplatin/PARP trial
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grateful for today Quote  Post ReplyReply Direct Link To This Post Posted: May 19 2013 at 12:07pm
CJWatson,

Great to hear how well your meeting with your radiation oncologist went.
I posted some radiation related info on
http://forum.tnbcfoundation.org/anyone-refuse-radiation-after-lumpectomy_topic11039_page2.html
that you may or may not be interested in.

With caring and positive thoughts,
Grateful for today.............Judy

=========================================

Carolyn,

Good to hear that you have completed your chemo and surgery part of your treatment plan.

Sounds like you have already signed up for the Cisplatin PARP inhibitor trial for after radiation
so you should be all set.   Just be aware and to be on the safe side, find out how many days
after the last treatment or surgery is the outer limit to be in the trial.   The information on
clinicaltrials.gov does not always include that info.   Again, since you have already signed up and
plan to start after radiation, sounds like all is OK.     Some trials require that one be within so many
days of the last "treatment" and some require to be within so many days of "surgery".

As mentioned above to CJWatson, I posted some radiation info on
http://forum.tnbcfoundation.org/anyone-refuse-radiation-after-lumpectomy_topic11039_page2.html
that you may or may not be interested in.

With caring and positive thoughts,
Grateful for today...............Judy
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Aug 12 2013 at 7:01pm
Ann Oncol. 2013 Aug 7. [Epub ahead of print]

Functional proteomics characterization of residual triple-negative breast cancer after standard neoadjuvant chemotherapy.

Source

Department of Breast Medical Oncology.

Abstract

BACKGROUND:

In this study, we used functional proteomics to determine the molecular characteristics of residual triple receptor-negative breast cancer (TNBC) patients after neoadjuvant systemic chemotherapy (NCT) and their relationship with patient outcomes in order to identify potential targets for therapy.

PATIENTS AND METHODS:

Protein was extracted from 54 residual TNBCs, and 76 proteins related to breast cancer signaling were measured by reverse phase protein arrays (RPPAs). Univariable and multivariable Cox proportional hazard models were fitted for each protein. Survival outcomes were estimated by the Kaplan-Meier product limit method. Training and cross validation were carried out. The coefficients estimated from the multivariable Cox model were used to calculate a risk score (RS) for each sample.

RESULTS:

Multivariable analysis using the top 25 proteins from univariable analysis at a false discovery rate (FDR) of 0.3 showed that AKT, IGFBP2, LKB1, S6 and Stathmin were predictors of recurrence-free survival (RFS). The cross-validation model was reproducible. The RS model calculated based on the multivariable analysis was -1.1086 × AKT + 0.2501 × IGFBP2 - 0.6745 × LKB1+1.0692 × S6 + 1.4086 × stathmin with a corresponding area under the curve, AUC = 0.856. The RS was an independent predictor of RFS (HR = 3.28, 95%CI = 2.07-5.20, P < 0.001).

CONCLUSIONS:

We found a five-protein model that independently predicted RFS risk in patients with residual TNBC disease. The PI3 K pathway may represent potential therapeutic targets in this resistant disease.

http://www.ncbi.nlm.nih.gov/pubmed/23925999

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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