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Old 06-14-2014, 06:10 PM   #1
LizB
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pathology results in chemo decision

Hi Friends,
I finished my 7th and last round of neo-adjuvant TCHP May 1st. So glad to be done but now results from surgery came back and I'm given the choice of whether to do 3 rounds of FEC chemo before radiation. I had 1 sentinel node positive for cancer and a 2nd sentinel node negative and a secondary node negative. They had clear borders from the lumpectomy.

What would you do? The node had very lacy cancer in a 2 mm tumor, only about 5% of active cancer in that tiny tumor. My original breast tumor was large, 6cm, er pos and HER2pos. Part of me says, yes, do the additional chemo and do all I can to lick this thing the first time out. The rest of me says, no, we still have 6 months of Herceptin, 6 weeks of radiation, and 10 years of hormone therapy coming up. Advice welcome.
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Old 06-15-2014, 02:10 PM   #2
tricia keegan
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Re: pathology results in chemo decision

Hi Liz, if its only three rounds I'd be inclined to do it, that way you know you've done all you can and thrown everything at this first time around, I think otherwise you may second guess the decision for a long time, just my thoughts!
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Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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Old 06-15-2014, 06:28 PM   #3
Nurse4u2day
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Re: pathology results in chemo decision

Lizb,
I just had my mastectomy on June 11th, left hospital on Friday. I am still waiting for my final path report. I have already had chemo. But if my oncologist said I would need a bit more then as bad as I wouldn't want to do it I would. After all we have come so far already. And I don't ever want to ask what if....
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]11/13 Dx IDC left breast
11/19/2013 Inflammatory Breast Cancer stage 3c grade 2 Er- Pr- her2+++
Node involvement suspected based on CT
12/13 port placed
12/13 neoadjuvant DD AC xs 4 rounds started
02/14 taxol/herceptin started every week xs 12 rounds
Herceptin for 1 year
Ki67=23%
BRCA1&2 negative
5/06/14 last round taxol/herceptin. Chemo done!!!
5/07/14 clear CT scan
6/11/14 Bilateral Mastectomy Done
6/15/14 8mm tumor post chemo. Removed by bmx
6/15/14 lymph nodes 0/9
6/15/14 officially Cancer Free
7/11/14 emergency surgery to left breast . Wound refused to heal and broke open. New TE placed
7/28/14 emergency medical procedure now to right breast( post op 6 weeks mastectomy ) wound opens.
8/25/14 - 10/07/14 Radiation
11/24/14 CT of Brain clear
01/23/15 One year Herceptin Complete
02/04/15 Diep done
5/01/15 1 year Ct scan- mass in thymus
6/23/15 repeat CT mass in thymus still present
6/30/15 biopsy thymus 7/03/15 mass Benign! Diagnoses Thymic hyperplasia rebound ( chemo at fault, no long term health effects)
7/08/15 phase 2 diep
11/23/15 phase 2b ( reconstructive surgery with lipo)
03/05/18 Vinnie Myer 3 D nipple tattoos complete.
11/19/2018 5 years since Dx of IBC stage 3c remain NED.
11/19/21- 8 years today I officially remain NED and in 12 days I will be having a lymphnode transfer to help decrease some mild lymphedema! Still working, living life and soon to see a day I thought never would happen and that’s becoming a grandparent June 22nd.
11/19/2023 - 10 years since diagnosis and I remain NED
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Old 06-16-2014, 04:58 AM   #4
Gail
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Re: pathology results in chemo decision

I try not to think about what is ahead of me and just get through the now. I've had 4 rounds of AC, went through 6 rounds of paclitaxel to find I couldn't tolerate it and have had to start again now with Docetaxel. I was due to be finished all chemo by end of June but now my end date is out to August. Then I need radio if my genetic testing is negative. Not thinking about what happens with a positive result yet. So I just have a sip of concrete, toughen up and get through it. I'm having a terrible time at the moment with the Decetaxel but I'm just counting the treatments down. I think of this as just a year I have to get through of chemo, radio and surgery and then it will be plain sailing with herceptin and tamoxifen. I also don't want to be sitting around in a few years if it comes back thinking God why didn't I just do it back then.

In saying that it's a very personal decision so you have to go with what you can tolerate. Not sure I could do it without my awesome family so just do what you think is best.
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DX 5th November 2013
Age 49 premenopausal
Lumpectomy (left) 19th November 2013
8mm, Grade 3 IDC,
Stage 1, node negative
ER++ PR+++ Her2+++, Ki67 70 - 80%
BRCA tested - negative
AC chemo began 3rd January 2014 (4 rounds) completed
Paclitaxel weekly for 12 rounds cancelled after round 6 due to neuropathy
Docetaxel began 30th May 2014 - 2 rounds completed 20th June
Herceptin (3 weekly for 1 year) began 11th April 2014
Radio completed 2nd September 2014
Long dates cause I'm an Aussie and will mess up if I try to do it your way :)

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Old 06-16-2014, 09:06 AM   #5
roz123
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Re: pathology results in chemo decision

hmmm that's a hard one. Seems you got standard of care up front. I didn't know they were doing chemo after if you had less then a complete response. I think its smart actually - the whole point of neoadjuvant.
if you were er/pr neg then I would say for sure do the extra chemo since there is no hormone therapy after. You are er positive so you still have hormone therapy and Herceptin.

I would get a second opinion for sure - this is not a standard protocol, maybe they can do a gentler chemo after instead?

that being said I did 3 rounds of FEC and if you control the nausea its not so bad

good luck with your decision
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diagnosed aug/11
right breast IDC 2.2 cm LVI
neoadjuvant fecx3, tax and her x3
surgery -pCR 0/2 nodes
25 rads
herceptin x18
tamox
prophy bi-msx with TE's oct 15/12
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Old 06-17-2014, 07:08 AM   #6
thinkpositive
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Re: pathology results in chemo decision

LizB,

If it were me, I would go ahead with the additional rounds of chemo. I know that chemo is brutal but it is also brutal for the cancer, which of course is a good thing. It is a personal decision so you will need to do what you feel comfortable with. For me, I know that if I declined the treatment and the cancer came back I would always wonder if it was due to refusing the additional rounds of chemo.

Make a decision that you can live with now and in the future.
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