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02-12-2014, 08:42 PM
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#1
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Senior Member
Join Date: Dec 2013
Location: Toronto, Canada
Posts: 26
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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).
__________________
2012-Feb-29 D-Day: IDC ER-/PR- HER2+++ Grade 3, Stage 3 - several biopsy proven positive nodes
2012-Mar - July: Neoadjuvant FEC-D + Herceptin (6 rounds)
2012-Apr: DVT in arm that received chemo - put on LMW Heparin
2012-Apr: Port installed
2012-Sep-7: Lumpectomy + ALND - pCR with residual DCIS
2012-Oct: Switched from LMW Heparin to Warfarin
2012-Oct-Nov: 30 days of rads
2013-Jan: Entered Adjuvant Metformin trial (Metformin or placebo for 5 years)
2013-Jan: Switched from Warfarin to Xarelto
2013-Mar: First signs of lymphedema
2013-May-16: Last Herceptin (17 doses in total)
2013-Jun: Port removed and anticoagulants stopped
2014-Mar: Lymphedema worsened and became unresponsive to treatment
2015-Apr: Started PENTOCLO protocol to attempt to improve radiation fibrosis
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02-12-2014, 08:45 PM
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#2
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Senior Member
Join Date: Jan 2014
Location: South Florida
Posts: 97
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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.
__________________
1/17/14 Day after 44th b-day, Got dx of 2 malignancies Rt breast; ER/PgR- HER2+
1/21/14 Biopsy of spot on left; normal
1/28/14 PET scan - CLEAR!
1/29/14 BRCA normal!
1/31/14 Sentinel node biopsy
2/5/14 Nodes are CLEAR! Stage I/IIa, N0, M0
2/13/14 Start Chemo, 6 rounds for 18 weeks prior to surgery
2/28/14 Port placed
3/6/14 Chemo Round 2
3/27/14 Chemo Round 3 (halfway done!)
4/11/14 u/s shows 2cm tumor about 2x5mm now!
4/17/14 Chemo Round 4
5/8/14 Chemo Round 5 and Daughter's Birthday :)
5/27/14 Last Chemo Party - Round 6
6/17 14 Herceptin only until next Feb.
6/20/14 BMX/Immediate reconstruction DONE
6/30/14 Path report back...NED!
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02-12-2014, 10:06 PM
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#3
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Senior Member
Join Date: Mar 2012
Posts: 199
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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
__________________
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
LD flap reconstruction (PM me if you want the details)
zoladex shots monthly until SOFT studies come out
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02-13-2014, 10:28 AM
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#4
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Senior Member
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
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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!
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02-14-2014, 07:45 PM
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#5
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Senior Member
Join Date: May 2006
Posts: 143
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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.
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02-15-2014, 01:07 AM
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#6
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Senior Member
Join Date: Dec 2012
Location: Attica, IN
Posts: 371
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Re: Neoadjuvant Roll Call
I did and it was a 12/13 since surgery
__________________
myleftlump.wordpress.com - started blogging my
IDC breast cancer
7/2012 diagnosed with multiple solid lesions
7/20/12 biopsy done. ER+ 30 PR -, HER+++,k167 80% Grade 2
9/2012 biopsy on lymph node - showed malignant
9/2012 Pre-adjunctive TCH chemo.
12/6/12 MRI after Pre-adj.
Results: Modest Decrease in size of left breast malignancy As well as the associated satellite lesions and auxiliary Adenopathy compared to prior study. Doctors hoped for better but good response it didn't grow.
12/18/2012 left masectomy with axillary nodes
Size 3.2 CM, Nottingham score 9/9
Grade 3, no evidence of in situ carcinoma
Areas of angiolymphatic are identified
Carcinoma is 0.5 cm from inked deep
Margin of excision
Attached axillary lymph nodes: metastatic
Carcinoma in 6 of 8 nodes.
Size of largest node 1.5 cm
Extracapsular
ER + 73%, PR+2%, HER2+
2/27/13 6 weeks of IMRT radiation finished
2/2013 Started on Tamoxifan 5 years.
8/2013 will take last Herceptin, 17 treatments total every 3 weeks.
BRCA1 & BRAC2 - Negative
August 28, 2013 DIEP flap on the left breast.
February 2014 Nip & Tuck
March 14, 2014 nipple reconstruction and removed port.
August 14, 2014 lump in lymph nodes under arm and above clavicle. Stage IV
August 28, 2014 herceptin And projeta starting and port put back in.
3/18/15 stopped arimidex.
3/18/15 progression....Tdm1
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02-15-2014, 08:43 AM
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#7
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Senior Member
Join Date: Jul 2013
Location: Katonah,New York
Posts: 228
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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?
__________________
3/11/13- normal mammo and US
4/30/13 Found pea sized lump while showering
5/10/13 core bx
5/15/13 dx IDC 1CM,
5/20/13 BRAC 1&2 neg
5/28/13 lumpectomy and SNB, ER/PR/Her-2+, Nodes neg,positive margins
6/13/13 revision of margins . Now clear
6/26/13 first TCH
Chemo Ninja~kutaki Zika Zukuchiri
10/18/13-Bx of calcification-neg whew
11/7/13 Started Radiation.
01/2014- Started Tamoxifen
06/09/14-Steriotactic BX left breast calcification-Benign
06/18/2014-completed one year of Herceptin!
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02-15-2014, 05:40 PM
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#8
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Senior Member
Join Date: Dec 2013
Location: Toronto, Canada
Posts: 26
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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.
__________________
2012-Feb-29 D-Day: IDC ER-/PR- HER2+++ Grade 3, Stage 3 - several biopsy proven positive nodes
2012-Mar - July: Neoadjuvant FEC-D + Herceptin (6 rounds)
2012-Apr: DVT in arm that received chemo - put on LMW Heparin
2012-Apr: Port installed
2012-Sep-7: Lumpectomy + ALND - pCR with residual DCIS
2012-Oct: Switched from LMW Heparin to Warfarin
2012-Oct-Nov: 30 days of rads
2013-Jan: Entered Adjuvant Metformin trial (Metformin or placebo for 5 years)
2013-Jan: Switched from Warfarin to Xarelto
2013-Mar: First signs of lymphedema
2013-May-16: Last Herceptin (17 doses in total)
2013-Jun: Port removed and anticoagulants stopped
2014-Mar: Lymphedema worsened and became unresponsive to treatment
2015-Apr: Started PENTOCLO protocol to attempt to improve radiation fibrosis
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02-16-2014, 06:42 AM
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#9
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Senior Member
Join Date: Jan 2008
Location: "Love never fails."
Posts: 5,808
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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
__________________
Jackie07
http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2
NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement （600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016
7-23-2018 9 mm groundglass nodule within the right lower lobe with indolent behavior. Due to possible adenocarcinoma, Recommend annual surveilence.
7-10-2019 CT to check lung nodule.
1-10-2020 8mm stable nodule on R Lung, two 6mm new ones on L Lung, a possible lymph node involvement in inter fissule.
"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa
Advocacy is a passion .. not a pastime - Joe
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02-16-2014, 11:47 AM
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#10
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Senior Member
Join Date: Apr 2013
Location: Lakewood, WA
Posts: 56
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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
__________________
- Age 54 at dx (April '13) Stage 2b, grade 3
- ER+ PR+ HER+, 9 cm tumor one breast and <0.5 cm in sentinal node
- BRCA1 and 2 negative
- Neoadjuvant TCH chemo started 5-15-13 (4 rounds, 3 weeks apart)
- Unilateral Mx w/expander 8-22-13 (right side)
- 5/5 nodes Neg
- clear margins but close. Tumor at removal down to 2.2 cm.
- Radiation 6 wks starting 10-17-13.
- Herceptin every 3 weeks until 4-23-14
- DIEP/Mastopexy 10-8-14, U of WA
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02-17-2014, 05:07 AM
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#11
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Senior Member
Join Date: Jul 2013
Posts: 260
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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
__________________
31mm Infiltrating duct carcinoma
Grade 3, ER/PR-, HER2+, Neg Sentinel nodes x 5
49mm field of DCIS
17 June '13: Screen detected impalpable mass, Mammogram neg, US.
25 June '13: Diagnosed after multiple biopsies and MRIs
28 June '13: Left lumpectomey
4 July '13: Left Mastectomy
12 August '13: Commenced TCH chemo
Mid December '13 : TCH finished. Herceptin continuing three weekly.
4 August 2014- Herceptin infusions finished.
END OF THERAPY - YAY!
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02-17-2014, 06:54 AM
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#12
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Senior Member
Join Date: Dec 2012
Location: Attica, IN
Posts: 371
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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
__________________
myleftlump.wordpress.com - started blogging my
IDC breast cancer
7/2012 diagnosed with multiple solid lesions
7/20/12 biopsy done. ER+ 30 PR -, HER+++,k167 80% Grade 2
9/2012 biopsy on lymph node - showed malignant
9/2012 Pre-adjunctive TCH chemo.
12/6/12 MRI after Pre-adj.
Results: Modest Decrease in size of left breast malignancy As well as the associated satellite lesions and auxiliary Adenopathy compared to prior study. Doctors hoped for better but good response it didn't grow.
12/18/2012 left masectomy with axillary nodes
Size 3.2 CM, Nottingham score 9/9
Grade 3, no evidence of in situ carcinoma
Areas of angiolymphatic are identified
Carcinoma is 0.5 cm from inked deep
Margin of excision
Attached axillary lymph nodes: metastatic
Carcinoma in 6 of 8 nodes.
Size of largest node 1.5 cm
Extracapsular
ER + 73%, PR+2%, HER2+
2/27/13 6 weeks of IMRT radiation finished
2/2013 Started on Tamoxifan 5 years.
8/2013 will take last Herceptin, 17 treatments total every 3 weeks.
BRCA1 & BRAC2 - Negative
August 28, 2013 DIEP flap on the left breast.
February 2014 Nip & Tuck
March 14, 2014 nipple reconstruction and removed port.
August 14, 2014 lump in lymph nodes under arm and above clavicle. Stage IV
August 28, 2014 herceptin And projeta starting and port put back in.
3/18/15 stopped arimidex.
3/18/15 progression....Tdm1
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03-12-2014, 08:13 PM
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#13
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Senior Member
Join Date: Dec 2013
Location: Toronto, Canada
Posts: 26
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Re: Neoadjuvant Roll Call
Annnnd... I'm no longer NED. I guess pCR is overrated.
__________________
2012-Feb-29 D-Day: IDC ER-/PR- HER2+++ Grade 3, Stage 3 - several biopsy proven positive nodes
2012-Mar - July: Neoadjuvant FEC-D + Herceptin (6 rounds)
2012-Apr: DVT in arm that received chemo - put on LMW Heparin
2012-Apr: Port installed
2012-Sep-7: Lumpectomy + ALND - pCR with residual DCIS
2012-Oct: Switched from LMW Heparin to Warfarin
2012-Oct-Nov: 30 days of rads
2013-Jan: Entered Adjuvant Metformin trial (Metformin or placebo for 5 years)
2013-Jan: Switched from Warfarin to Xarelto
2013-Mar: First signs of lymphedema
2013-May-16: Last Herceptin (17 doses in total)
2013-Jun: Port removed and anticoagulants stopped
2014-Mar: Lymphedema worsened and became unresponsive to treatment
2015-Apr: Started PENTOCLO protocol to attempt to improve radiation fibrosis
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03-13-2014, 01:19 AM
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#14
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Senior Member
Join Date: Jul 2013
Posts: 260
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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
__________________
31mm Infiltrating duct carcinoma
Grade 3, ER/PR-, HER2+, Neg Sentinel nodes x 5
49mm field of DCIS
17 June '13: Screen detected impalpable mass, Mammogram neg, US.
25 June '13: Diagnosed after multiple biopsies and MRIs
28 June '13: Left lumpectomey
4 July '13: Left Mastectomy
12 August '13: Commenced TCH chemo
Mid December '13 : TCH finished. Herceptin continuing three weekly.
4 August 2014- Herceptin infusions finished.
END OF THERAPY - YAY!
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03-13-2014, 07:58 AM
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#15
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Senior Member
Join Date: Dec 2012
Location: Attica, IN
Posts: 371
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Re: Neoadjuvant Roll Call
__________________
myleftlump.wordpress.com - started blogging my
IDC breast cancer
7/2012 diagnosed with multiple solid lesions
7/20/12 biopsy done. ER+ 30 PR -, HER+++,k167 80% Grade 2
9/2012 biopsy on lymph node - showed malignant
9/2012 Pre-adjunctive TCH chemo.
12/6/12 MRI after Pre-adj.
Results: Modest Decrease in size of left breast malignancy As well as the associated satellite lesions and auxiliary Adenopathy compared to prior study. Doctors hoped for better but good response it didn't grow.
12/18/2012 left masectomy with axillary nodes
Size 3.2 CM, Nottingham score 9/9
Grade 3, no evidence of in situ carcinoma
Areas of angiolymphatic are identified
Carcinoma is 0.5 cm from inked deep
Margin of excision
Attached axillary lymph nodes: metastatic
Carcinoma in 6 of 8 nodes.
Size of largest node 1.5 cm
Extracapsular
ER + 73%, PR+2%, HER2+
2/27/13 6 weeks of IMRT radiation finished
2/2013 Started on Tamoxifan 5 years.
8/2013 will take last Herceptin, 17 treatments total every 3 weeks.
BRCA1 & BRAC2 - Negative
August 28, 2013 DIEP flap on the left breast.
February 2014 Nip & Tuck
March 14, 2014 nipple reconstruction and removed port.
August 14, 2014 lump in lymph nodes under arm and above clavicle. Stage IV
August 28, 2014 herceptin And projeta starting and port put back in.
3/18/15 stopped arimidex.
3/18/15 progression....Tdm1
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03-13-2014, 11:00 AM
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#16
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Senior Member
Join Date: Mar 2012
Posts: 199
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Re: Neoadjuvant Roll Call
broccoli so so sorry....please update when you can, sending prayers your way.
__________________
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
LD flap reconstruction (PM me if you want the details)
zoladex shots monthly until SOFT studies come out
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03-13-2014, 11:47 AM
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#17
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Senior Member
Join Date: Dec 2012
Location: Attica, IN
Posts: 371
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Re: Neoadjuvant Roll Call
Brocoli,
I am so sorry about you not being NED anymore!!! YUCK! What will they treat you with now???
__________________
myleftlump.wordpress.com - started blogging my
IDC breast cancer
7/2012 diagnosed with multiple solid lesions
7/20/12 biopsy done. ER+ 30 PR -, HER+++,k167 80% Grade 2
9/2012 biopsy on lymph node - showed malignant
9/2012 Pre-adjunctive TCH chemo.
12/6/12 MRI after Pre-adj.
Results: Modest Decrease in size of left breast malignancy As well as the associated satellite lesions and auxiliary Adenopathy compared to prior study. Doctors hoped for better but good response it didn't grow.
12/18/2012 left masectomy with axillary nodes
Size 3.2 CM, Nottingham score 9/9
Grade 3, no evidence of in situ carcinoma
Areas of angiolymphatic are identified
Carcinoma is 0.5 cm from inked deep
Margin of excision
Attached axillary lymph nodes: metastatic
Carcinoma in 6 of 8 nodes.
Size of largest node 1.5 cm
Extracapsular
ER + 73%, PR+2%, HER2+
2/27/13 6 weeks of IMRT radiation finished
2/2013 Started on Tamoxifan 5 years.
8/2013 will take last Herceptin, 17 treatments total every 3 weeks.
BRCA1 & BRAC2 - Negative
August 28, 2013 DIEP flap on the left breast.
February 2014 Nip & Tuck
March 14, 2014 nipple reconstruction and removed port.
August 14, 2014 lump in lymph nodes under arm and above clavicle. Stage IV
August 28, 2014 herceptin And projeta starting and port put back in.
3/18/15 stopped arimidex.
3/18/15 progression....Tdm1
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03-15-2014, 06:38 AM
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#18
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Senior Member
Join Date: Jul 2013
Location: Katonah,New York
Posts: 228
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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!
__________________
3/11/13- normal mammo and US
4/30/13 Found pea sized lump while showering
5/10/13 core bx
5/15/13 dx IDC 1CM,
5/20/13 BRAC 1&2 neg
5/28/13 lumpectomy and SNB, ER/PR/Her-2+, Nodes neg,positive margins
6/13/13 revision of margins . Now clear
6/26/13 first TCH
Chemo Ninja~kutaki Zika Zukuchiri
10/18/13-Bx of calcification-neg whew
11/7/13 Started Radiation.
01/2014- Started Tamoxifen
06/09/14-Steriotactic BX left breast calcification-Benign
06/18/2014-completed one year of Herceptin!
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12-20-2014, 10:13 AM
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#19
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Senior Member
Join Date: Dec 2013
Location: Toronto, Canada
Posts: 26
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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!
__________________
2012-Feb-29 D-Day: IDC ER-/PR- HER2+++ Grade 3, Stage 3 - several biopsy proven positive nodes
2012-Mar - July: Neoadjuvant FEC-D + Herceptin (6 rounds)
2012-Apr: DVT in arm that received chemo - put on LMW Heparin
2012-Apr: Port installed
2012-Sep-7: Lumpectomy + ALND - pCR with residual DCIS
2012-Oct: Switched from LMW Heparin to Warfarin
2012-Oct-Nov: 30 days of rads
2013-Jan: Entered Adjuvant Metformin trial (Metformin or placebo for 5 years)
2013-Jan: Switched from Warfarin to Xarelto
2013-Mar: First signs of lymphedema
2013-May-16: Last Herceptin (17 doses in total)
2013-Jun: Port removed and anticoagulants stopped
2014-Mar: Lymphedema worsened and became unresponsive to treatment
2015-Apr: Started PENTOCLO protocol to attempt to improve radiation fibrosis
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