Intro + Neoadjuvant or Adjuvant Chemo?
Hi all, My wife's just been diagnosed with Invasive Ductal Carcinoma NST (Grade 2-3) ER+, PR+, HER2- with a 29mm tumour and at least 1 involved lymph node. Needless to say it's hit us like a bus and we're in that dark, foggy place pre-treatment where we have no idea what's coming up next. That said, things have, luckily, moved pretty quickly since the first GP meeting for the initial pathology referral. In the 9 days since visiting the GP, we've had imaging with a mammogram and ultrasound which indicated suspicious findings, then 2 days later a biopsy, followed a day later by the meeting at the GP to get the bad news. Since then we've had our initial meeting with the surgeon at the RBWH, Dr Wong (who seemed very capable, but if anyone else has had him as their surgeon I would still love to hear more about your experience) and some of the MDT. We have our first meeting with Medical Oncology next Friday and the 2 week follow up with the MDT the following week. During the initial discussion our doctor classified this as "Early Stage" cancer (something we're hanging hope on) and said that we would have a number of options for treatment. My wife's family has quite an extensive history of cancer (mostly breast, with some throat / ovarian), however her Mum was genetically tested years ago and is apparently BRCA negative. When asked what we would prefer as a treatment, we just said we'd rather have a double mastectomy to reduce any chances of recurrence later, however when Dr Wong came in, he had a good chat with us and asked if we were making decisions from an emotional place rather than a practical place. His suggestion is to pursue a neoadjuvent treatment course, followed by genetic testing and then surgery, which if the chemo was effective would possibly mean just a lumpectomy rather than a mastectomy as well as potentially saving some lymph nodes. Unfortunately we're very sleep deprived and still in a bit of shock so we're not sure what to do. Basically we see it one of two ways: 1. Do the chemo, hope that it shrinks everything (or God-willing completely disappears it) while killing anything else that might be floating around, then do the surgery, then radiation if required. 2. Go the surgery, remove everything including lymph nodes, then hit hard with chemo and radiation if needed to try and smash anything that's left. Honestly, I get the idea of "patient-centered" treatment where your opinions and wishes are taken into account, but I know if I had a client approach me as the subject matter expert for a highly technical quote on something they didn't know anything about and I asked them to tell me what they thought would be the best option, I wouldn't have a job. This sounds so dumb, but I just want to say something like "wait a second, why are you asking us what treatment should be? Aren't you the expert???" We want to be very positive and forward leaning with this journey and I feel like we have to have an element of trust in the MDT and the process, but could do with some perspective. Sorry for the wall of text, I blame the lack of sleep! George1.2KViewsSign in to react to this post30Comments
Triple positive..but invisible on screening tests
Just diagnosed in September after finally pushing my GP for an answer on what this lump actually was that was getting bigger in left breast. Negative results on screening mammograms and ultrasound. Surgeon wasn't concerned but did a biopsy - Triple positive. Then did a lumpectomy 4wks later but it was bigger than he thought and did not result in clear margins and one lymph node affected.. Soooo... am now on day 2 post 1st chemo treatment and, so far, so good. I'm taking preventative medications recommended by oncologist to avoid the nausea, bone pain, mouth tenderness that seem to be common... but my gut is churning a bit.. I am in a regional centre and have decided to have my mastectomy in Melbourne as they can also do a reconstruction at the same time. Whirlwind and roller coaster and waves are the emotional analogies I seem to use. It's reassuring to know that many, many others have experienced this stuff and got through it in their own ways. Always keen for tips and tricks :)ViewsSign in to react to this postCommentsNewly diagnosed - Triple Negative Breast Cancer
Original post by @MargieD moved from activity section to 'Newly Diagnosed' discussion thread:ViewsSign in to react to this postComments
originally thought to be DCIS but post surgery biopsy result confirmed multifocal invasive carcinoma
Hi all, I am new here and have been struggling a little with my rollercoaster of a diagnosis. 6 weeks ago I found out I had breast cancer. 4 weeks ago I had surgery to remove what was thought to be DCIS as the ultrasound, mammogram and MRI results all confirmed it was definitely a DCIS however at the same time they all picked up a suspicious lesion next to the DCIS that imaging could not determine and the surgeon advised they would remove that area during surgery also for biopsy. The post operation biopsy came back a week later and I ended up being diagnosed with mutlifocal invasive carcinoma including Grade 2 mucinous carcinoma, Grade 2 lobular carcinoma in addition to the DCIS. The lobular carcinoma was also found in my sentinel lymph nodes. I am now well educated enough to know that there is a sneaky breast cancer that can go undetected that I was not aware of before. I go every year for a routine check and if it wasn't for the DCIS this would not have been picked up that easily. I am now in stage3, ER+ PR+ HER2 Negative. My PET/CT Scan was clear of spread to other parts of the body however my surgeon advised given the extent of it that I undergo chemo first before I have full mastectomy and removal of lymph node surgery. I can understand why but my mind would be at more ease if I had everything removed now. I have seen the oncologist already and will have chemo therapy for 26 weeks starting next week. Waiting also for confirmation of when I start chemo has not been easy for me either even though I have had several medical professionals ensure me that it wont compromise my current diagnosis and that my cancer type is not aggressive etc. I have came here to find out if anyone else has been in a similar situation as I am struggling to find anyone I can talk to that has been in the same boat.ViewsSign in to react to this postComments
Surgery Before Further Chemo??
Hi all you lovelies, Can anyone tell me if it is possible to have surgery before my next lot of Chemo change. I have TNBC my tumour was quote large and I was informed by the surgeon that it was too large to operate straight away and that I would have chemo to shrink it first. I have been having chemo every 2 weeks for 8 weeks, I am then supposed to start my next course of 12 x weekly. However, as the tumour has shrunk to next to nothing already, can anyone tell me why having the double mastectomy now and not continuing with the next round is not an option. I was not able to get a straight answer from the Oncologist except for "this is the way we normally treat it". Surely if the Breast tissue is no longer there, then the likely hood of recurrence and not to mention that they want to do Radiation after surgery anyway, is slim. Any ideas??ViewsSign in to react to this postComments
What a ride!
Good morning everyone, it’s 4.30am and I’m awake again. I was called back after a routine mammogram, biopsy done, initial result, 2cm grade 2, action plan lumpectomy, 6wk radiation. Go in to sort surgery date the next week, more pathology results have come in and show I have triple negative, grade 3 with a Ki67 of 90%. Oncologist next, chemo scheduled every 2wks AC for 4.5 months. Lymph node surgery this week. Genetic testing recommended. Life can change so quickly. Hardest bit to date, telling my daughters. I’m otherwise healthy, fit, strong and young (their description) at 55, nothing else wrong with me, no medications, I’m a horse rider and live on 15acres, I live an active life. Im worried, but trying not to be, I’m expecting to get the news that this has spread. Im on the roller coaster! Never did like them. On the positive side, everyone has been fantastic, Breast Clinic, Surgeon, Oncologist, Breast Care Nurses, everyone I’ve met so far, I’ve been impressed with the professionalism and care shown and it is very much appreciated.ViewsSign in to react to this postComments
Research Trials
I am new to the community - Hi. I have a question for people who are undergoing dose dense AC and Taxol for triple Negative breast cancer, in relation to how much exercise or movement they are doing. Background: I was diagnosed in May and have a treatment plan that is slightly altered - I have chemo, then surgery and then radiation. I have a triple neg invasive carcinoma ( it was 1 cm at diagnosis now 6 mm and shrinking (shrink MOFO SHRINK)) and a 3 cm area of DCIS in one boob. I was invited to take part in an exercise research trial. I am pre menopausal and I was already moderately fit + active. This trial has required me to walk 8 k steps per day and do weights 3 x a week during chemo. I am enjoying the golden elixir (chemo) of dose dense AC + Taxol for 20 weeks. Halfway there at 10 weeks done. The research trial is looking to establish if i can maintain muscle mass, invoke the sympathetic nervous system, impact of my bone density and what impact exercise has on treatment and side effects of Chemo. I was required to lift weights and do a heavy workout post chemo (AC). QUESTION/Discussion: I was wondering how other people on the same chemo treatment are doing in terms of moving and exercising ? Are other people able to maintain prior exercise regimes ? Have you made it part of your habit. If there was a trainer or an exercise professional would you be interested in working out post chemo (directly after infusion). I can’t swim anymore as I am an ocean swimmer and with a chest infection and neutropenia and low haemoglobin advice from the doctor was hell no. So i am left with pilates, weights and walking.ViewsSign in to react to this postComments
Chemo before surgery OR surgery before chemo???
Good morning, I received my results yesterday and the surgeon suggested a 4 month cycle of chemo (apparently my body can take it??) before a full mastectomy. Is this normal? Or do most have surgery before the chemo? I am very scared about the chemo - probably the unknown and being so sick for so long. I have two little girls who need their Mumma .... Any advice would be greatly welcomed xxViewsSign in to react to this postComments
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