Revisiting pCR, partial response, and prognosis
 

I am still looking for the latest pCR data, but am resharing this posting from Lani on partial response:

My goal is to share with those who have had a complete response or partial response the experience of others - so perhaps our fellow board members can worry less . . . and enjoy their recovery from cancer treatment more.

Re: Revisiting pCR, partial response, and prognosis
 

Hi Lizbeth, thank you for this post. I did not get pCR after neoadjuvent chemo. I must say I was very upset and scared even though we don't really know what that means since NAC is a more recent way of doing things. Anyway, what I get from this is that the tissue that was removed after surgery should be tested and path results should be done to see what the Ki-67 is. I don't know if path results were done on it, I will call my surgeon and find out!!

Re: Revisiting pCR, partial response, and prognosis
 

Kathy,

Cancer can be scary, however many of us worry too much (myself included) about things that will never happen (recurrence).

Did you have a partial response to TCHP?

Ask him if the number for your ER+ changed as well as Ki-67.

Best wishes for NED

Re: Revisiting pCR, partial response, and prognosis
 

I did lizbeth, there were only 2mm and a 4mm area of cancer left behind and lymph nodes were clean at the time of surgery. Thanks!

Re: Revisiting pCR, partial response, and prognosis
 

That sounds very positive. I am really glad the lymph nodes were clean and the cancer shrunk so much.

Re: Revisiting pCR, partial response, and prognosis
 

Hi Lizbeth,

Thanks for posting this. I could really use your help! I was diagnosed stage IIB, HER2+, ER-,PR- , one positive node, in Dec, 2014. After receiving 6 rounds of TCHP and then a bilateral mastectomy 2 weeks ago, I just got my pathology report. Unfortunately, I did not get a pCR (crushing!) though they said my response was pretty good -- the breast tumor was gone and cancer in my node was nearly gone- 4.5 mm left. (8 other nodes removed- all clear). However, because of the cancer left on node, my doctor has suggested I go in for more chemo, AC this time, because she is worried about rogue cells in my body. I will do anything to reduce my risk of recurrence, but I'm super nervous that I didn't get pCR after what I've been reading in the research (and also about going on AC frankly). Should I request they check the Ki-67? Anything else I should be asking? What do you think about using AC at this point?
Thank you!
Amy
San Francisco

Re: Revisiting pCR, partial response, and prognosis
 

Amy,
I would maybe get a second opinion?? I think I would request Ki-67! I did have clean lymph nodes but did not get pcr in my 2 small tumors in my breast. I asked my MO about more chemo after I found out I did not get pcr(I was crushed too) and he did not recommend it.
Best of luck to you!!

Re: Revisiting pCR, partial response, and prognosis
 

Hi Amy, my loved one's response to chemo was almost the exact same as yours, what a coincidence! I like you was crushed, but it is a very good response. AC chemo alone is not as effective in her2+ and it is viewed by more as the tougher chemo. In my loved one's case, she got strong radiation and the year of herceptin, as well as tamox because of hr+. No more chemo.


I would definitely seek a second opinion, you will drive yourself crazy thinking of what ifs.


Re: worrying about the lack of complete response. Only 40-60% (based on the studies I've read) have a pcr with perjeta, so people with a non full response is a substantial group, you are not alone. Hope this helps.

Re: Revisiting pCR, partial response, and prognosis
 

Thanks Kathy and ConcernedStu. I appreciate your sharing.

I definitely was hopeful for pCR because my response seemed to be so good during treatment (and mostly it was since tumor in breast was gone). I keep wondering if the cancer on node was just so fibrous that the chemo couldn't get it all. Unfortunately, because I don't have ER+ cancer, my doctor can't give me Tamoxifen or other estrogen-suppressing drugs, thus she has to be more aggressive with treatment to make sure any potential floating cells are zapped to smithereens. She's consulting with her tumor board now as well as others at a big conference in Chicago so I will hear her final recommendation soon but I am anticipating more chemo. If that's what it takes, I'm good with it. Like so many women here, I am a mom of young children and will do whatever they tell me. I keep thinking I may get more battle wounds but it's worth it as long as I win the war.

Hope everyone out there is winning their wars and kicking cancers ass! :)

Re: Revisiting pCR, partial response, and prognosis
 

I hate Cancer and wish it didn't have to come in to any of our lives. I, like you have small children and would do anything to reduce the chance of it coming back. Please keep us posted!!

Best wishes
Kathy

Re: Revisiting pCR, partial response, and prognosis
 

Amy,

Please keep us posted on what treatment they recommend for you. I am also ER/PR negative. Although I did have a pCR, I always wonder if they could have missed something in the nodes because they didn't to an axillary node dissection but rather a sentinal node biopsy. My cancer, like yours, was discovered in my nodes so I did have cancer in my nodes prior to treatment.

I like your Oncologists approach to be aggressive and get those remaining cancer cells. Sounds like you are in good hands.

Take care,
Brenda