Neoadjuvant Roll Call
 

I'm curious who all had or is having neoadjuvant chemo. For those who have had surgery since chemo, how much cancer was left? How long has it been since surgery?

I had neoadjuvant FEC-D + Herceptin from March to July 2012 (and May 2013 for Herceptin). Surgery in September 2012 showed only residual DCIS. No changes since then (cross fingers).

Re: Neoadjuvant Roll Call
 

I have my first round tomorrow. Know for sure it is Perjetta and Herceptin along with other chemo meds (forgot names), for the next 18 weeks; 6 cycles, then surgery this summer and Herceptin to follow.

Re: Neoadjuvant Roll Call
 

im just over 2yrs out from the end of chemo

I had a complete response, only some residual dcis at surgery

Re: Neoadjuvant Roll Call
 

LOL, you all make me feel like a dinosaur. I did chemo way back in the old days, when it was after surgery!

Re: Neoadjuvant Roll Call
 

I had neo adjuvant chemo in '05! Stage 3, disappointing response to chemo…but
still healthy almost 9 years late!
her+, er/pr-, stage 3a after chemo, 2005. Alive and thriving, 2014.

Re: Neoadjuvant Roll Call
 

I did and it was a 12/13 since surgery

Re: Neoadjuvant Roll Call
 

I did not have neoadjuctive chemo, I had lumpectomy then chemo and Rads, but this raises a question....when I finished my chemo I had a follow up mammo and the radiologist was concerned about some calcifications (could be DCIS). It was recommended that the area be biopsied. I agreed and Thank God it was not... But.... Having just had chemo, shouldn't that have wiped out any DCIS That may have been hiding? I know I sound naive but hell, I went throughout the chemo in case a rouge cell got free. Why would I not expect it to wipe out DCIS, Kinda like neoadjuctive . When I asked this of my onc, she didn't agree with my thinking....thoughts anyone?

Re: Neoadjuvant Roll Call
 

Coux92 - DCIS tends to be non-responsive to chemo. I have yet to come across a decent explanation for this. I even asked my brainwave medical onc and he couldn't really explain WHY just that that's how it is.

The good thing is that by definition DCIS is confined to the breast.

Re: Neoadjuvant Roll Call
 

Probably because DCIS is not considered cancer? If it's just calcification, the calcified 'stone' certainly would not respond to chemo. Chemo works by stopping the cell division - thus only fast-growing cells will respond to the treatment. I was also wondering about the 'stem cancer cells' that are not responding to the usual cancer treatment.

Not sure if the abstract below explains anything to the question:

http://www.ncbi.nlm.nih.gov/pubmed/24068769

Re: Neoadjuvant Roll Call
 

I had neoadjuvant TCH last summer; 4 round 3 weeks apart. Last one July 22 or 23.

I started out with a large tumor of 9 cm. I think that was why they recommended chemo first--to reduce the tumor size. At surgery the mass had been reduced to 2.3 cm ( or whatever it says in my signature...don't remember at this point). So it had a big impact, though not a complete response. I was told only 7 % of patients have a complete response from neoadjuvant chemo.

Even with a complete response they said a unilateral mastectomy followed by rads would be the plan. I was told I could do a bilateral if I really wanted but I chose uni. (I am 54 w neg brca 1/2).

So far so good, just waiting to trade the expander for something else.

Shirley

Re: Neoadjuvant Roll Call
 

I don't think we know why DCIS persists after neoadjuvant therapy but is doesn't appear to affect outcome. Of course, with neoadjuvant therapy, the whole breast is excised so residual DCIS can't do any harm.

In the lumpectomy/ chemo/rads scenario - the known DCIS is excised, but some could still be present. However, DCIS is non-invasive and most DCIS never progresses. Follow up of breast cancer treated this way has shown very good disease free survival comparable to mastectomy with only a slightly greater risk of local recurrence (treatable with surgery.)

See the speculation below.


http://jco.ascopubs.org/content/25/19/2650.full

"It is biologically quite intriguing that DCIS, not unlike normal breast epithelium, often survives chemotherapy. Differences in proliferation rate cannot fully explain the greater chemotherapy resistance of in situ cancer because these lesions frequently have growth fractions higher than corresponding normal tissues and similar to that seen in invasive cancers.26,27 It is possible that physiologic resistance mechanisms that protect normal cells from cytotoxic insults remain more intact in in situ cancers compared with invasive tumors.28 However, greater drug resistance of these tumors may be of limited clinical relevance because, by definition, in situ cancers do not metastasize."

Aussie Girl

Re: Neoadjuvant Roll Call
 

My understanding was pre-adjunct first to stop the spread of the cancer systemically because I had multiple tumors one being like 5 cm, another being 3.2 and then the rest tiny little ones that looked like someone sprinkled pepper all over. Then in my lymph nodes as well......So stop the spread of the cancer the GOAL with pre-adjunctive therapy. I had very little pathologic response if any, so I have no idea if it at least went through my system and killed all those little micro cancer cells in my body they could not see. On a positive note my BS got .5 cm clear margins at surgery!! Whoo, hooo. :)

Hopefully, the Armidex I am now taking will take are of the ER+30 then went to ER+73 percent....I still don't know if that is a good thing or what that even means.

Sorry, but I am no help, because it is all VERY CONFUSING!!

On a positive note I had a complete body massage this weekend and Sunday I was sore has heck, but today my feet and hands feel a little better. :) It is Chinese reflexology which I find extremely fascinating. He told me after with a Asian accent that, "I had poor circulation in my feet" he can work on those and make body feel better!! He said my hands hurt too because nerves coming from my shoulders sooo tight that he can make better too....come back once a week (In my Mr. Miagi, Karaote kid voice). I did not tell him anything that hurt, so very COOL he figured it out. I don't know maybe because my toes were ICE cold..LOL

Re: Neoadjuvant Roll Call
 

Annnnd... I'm no longer NED. I guess pCR is overrated.

Re: Neoadjuvant Roll Call
 

That is a total bummer, broccoli. So sorry to hear. When you know more about what's happened and potential treatment, post a new thread and let us know. We'll be thinking of you.

Aussie Girl

Re: Neoadjuvant Roll Call
 

You are 6 years out Lizabeth....Stone age treatment!! :):):)

Re: Neoadjuvant Roll Call
 

broccoli so so sorry....please update when you can, sending prayers your way.

Re: Neoadjuvant Roll Call
 

Brocoli,

I am so sorry about you not being NED anymore!!! YUCK! What will they treat you with now???

Re: Neoadjuvant Roll Call
 

I'm so sorry broccoli, I'm keeping you in my prayers and wait to hear better news from you soon! Stay strong!

Re: Neoadjuvant Roll Call
 

Quick update: back to NED. It took 9 months of various scans and exams due to the number of issues and symptoms I've been having, but as of a final MRI on Wednesday night, I can confidently say that there still appears to be no active disease!