platin for early stage TN

brca1babe

Has anyone heard of has anyone received a platin for early stage TN?  I have read how some TN (basal-like and BRCA-related, which I am) responds really well to platins.  my MO says it is not ready for prime time (not enough clinical studies) and prescribed AC.

Has anyone had an MO prescribe a platin for stage I or II TN?

Now that I have only one more AC treatment to go, I am fearing I haven't had the right chemotherapy or not enough.  I know this is a common worry... but I am still worried!

I don't really want more chemo on the one hand, but now I am thinking about trying to get on cisplatin or carboplatin.  Am I crazy?

mccrimmon324

I don't think your crazy, I'm doing 6 rounds of TAC, I'm only 1/2 way thru and am thinking of talking to my dr about more chemo, I really don't want more chemo but I want to make sure they've got it all! 

sewingnut

what is a platin?

Suze35

I was a little more advanced at diagnosis - Stage IIb-IIIa - and I did have Carboplatin with my Taxol.  Unfortunately, it stopped working about 2/3 of the way through, although I did have an initial great response.  I had my chemo neoadjuvantly.

Are you doing Taxol?  Have you had surgery yet?  If not, I would recommend waiting to see how you responded to the AC - get an MRI before surgery for an idea.

If you have had surgery, then it is a tough call.  Some things to think about are size of tumor, lymph nodes involved, and lymphovascular invastion.  If your tumor was small, no nodes, and no LVI, then that has a better prognosis. 

I know our first instinct is "more chemo!" but you also don't want to risk future problems if it isn't necessary.  And in my case, it didn't make a difference.

I wish you luck with your decision!

brca1babe

I had a BMX for what I thought was DCIS (and being brca1 pos, wanted to get the BMX anyway) and they found a 0.5cm IDC TN, node neg.

I think what's hard is it not being neoadjuvant chemo, I don't know if it is helping.

My MO doesn't rec taxol for me b/c (he says) it is not very effective against basal-like/ brca1-related TN and isn't worth adding it in my case.  he did do testing to see if it was basal-like and it was which was the clincher in terms of deciding to do chemo and going for adriamycin. hard to know what to do.  as you may know some with 0.5cm tumors don't get chemo at all.

I guess since I am questioning the plan, I should get a second opinion... once I feel up to it that is, AC is still kicking my butt!

Deeay

Hi-I'm currently receiving Taxotere with Carboplatin for Stage 11A TNBC. I previously received AC for an ER+ tumour that I had a lumpectomy for in 2009. Now I'm having 6 rounds every 3 weeks. I think my Oncologist had to get special permission for one of the drugs to be funded on our free pharmaceutical benefits scheme (PBS) (I'm in Australia) as it isn't the usual procedure. I'm hoping it works because that's all I've got! Can't have Radiation again!!!! 

sylviaexmouthuk

Hello Deeay

I have just read your post with great interest, especially about a recurrence (or primary) that is TNBC, when the first one was hormonal. I thought you might be interested in joining the discussions on the thread "Calling all TNBCs in the UK". Women from other countries are posting here.

On the thread we have been discussing about the changes in tumours etc. You are welcome to join us.

I hope all will go well with you. I had Taxotere in 2006 and it does leave an awful metallic taste in your mouth and makes your food taste horrible. We have been discussing that as well as we have talked about chemotherapy. I am sure you will be able to find someone on our thread who ius having Taxotere and Carboplatin.

Best wishes

Sylvia

Suze35

brca1babe - definitely get a second opinion if you are unsure of any part of your treatment plan.  It is a tough call - you have great stats in terms of prognosis, but your tumor was basal-type, so I can see your concern.   

Flautalee

I agree that Adriamycin/Cytoxin is tough, but it put me into remission for almost 11 years with only 4 rounds of it. The tumor was stage 2A (no pos. nodes, but about the size of a golf ball). This time it's 9mm X 1.0 cm. My Pet scan was negative and my tumor markers in normal range, so it looks like I don't have any mets. I will find out 7/11 what the plan is for me this time. Best to you!

brca1babe

wow lgkoss, that's encouraging. 

I guess I have been struck with the thought that AC alone maybe isn't enough chemo and I should do more...I think this is a common fear as chemo comes to an end.  I also had a delay between surgery/BMX and chemo (almost 12 weeks) that's not ideal that scares me. 

how did you find your recurrence?

Flautalee

Dear brca1babe--Well it's a long story.  My surgeon had been prescribing approx. yearly breast MRI's for me for the 6 or 7 years I've been going to her.  When she did so last year, my insurance denied the breast MRI, saying a mammo was all that was necessary.  My surgeon and I were unsuccessful in appealing and I did not want to have a mammo with 9 - 10 year old implants (I had prophylactic surgery on my right breast in 2001).  About three years ago my wonderful oncologist started having me come in every 3 months because my sisiter was dying from metastatic breast cancer (double neg, plus), which of course was very sad and stressful for me. Well, an acquaintenance at church told me in early March that insurers are now covering triple negs like us for breast MRI's, so I asked my oncologist about it at my next appointment.  The MRI was suspicious and I followed up with an ultrasound in May.   The Ultrasound MD who did my needle biopsy on June 6 said that the nodule would not have shown up on a mammo.  Then followed waiting for a PET scan, waiting for the Tumor Board recommendations, and finally surgery on July 22 to remove the tumor.   I will learn about the chemo/radiation at my oncology appt this Thursday.  So, we'll see!  Best.

Flautalee

Hello everyone-

I am still waiting to learn my oncologist's recommendations for treatment.  At my visit on 8/11 he asked me to get the slides from my 7/22 surgery and discs for my breast MRI and diagnostic US from the hospital where I had had them done so that the pathologists at his hospital can compare the new slides with the ones from 2000. (my previous surgeon was from the same hospital as my oncologist).  It actually made me feel good to be helpful.  I got the slides to my oncologist the same day and the discs the next.  But the waiting is tough as we all know.  He said he would have me come back this week.  Best.

Flautalee

Hello everyone -

I think that today I will learn the plan! I also changed my name from lgkoss to flautalee, because I am a flutist/flautist.  Best to all of you. 

SunnyCoconut

flautalee - What were the results?  Wishing you the best!

Flautalee

Hi SunnyCconut and everyone -

Well...last Friday I learned that my oncologist wants me to have 6 rounds of Taxotere/Cytoxan followed by radiation.  He said that my recurrence is actually a new primary tumor (go figure) because the cancer cells were different from 2000.  He will stop the Taxotere if I have any finger neuropathy and switch to something else.  He said that if I can even get 2 doses of Taxotere in, my risk of recurrence will be much lower.  Radiation to my breast area, focus on the area near the new tumor, the neck lymphatics and those under my arm.  So...I begin chemo this Friday (8/26).  Thanks for wondering how things are going with me.

PS.  He said that if I had insisted on not having a taxane, he would have used the alternate plan from the start..  But I respect his knowledge and experience.  I also read on the Taxol forum that Taxotere has fewer neuropathic side effects than Taxol. 

Meggy

Back when I did chemo, they gave AC with Taxol....The last time I asked my oncologist she said they were still doing this but I never know if she is trying to make me feel I got the right chemo. 

Afterwards, I did Carboplatin with Taxotere....I think they are very big guns.  I was a lot of chemo but I've never regreted it.  

Luah

Meggy, I'm not sure about that -  I often see TC prescribed for women with smaller tumours and no node involvement. I think AC-T (or FEC-D, common outside of U.S.) has been considered the big guns - and probably still is. Is there any head-to-head comparison, I wonder? I do know there was a recent study showing that giving the taxane first was better, so maybe there's more T-AC going on too.

mccrimmon324

I was under the impression if your TN you get the big guns reguardless of tumor size / node involvement?  My onco has me on TAC x 6, really hoping they're the most current big guns. 

Flautalee

Hello,

I hope everyone is doing well.  My oncologist told me that I can't have Adriamycin again (I had 4 rounds of A/C in 2000) for TN, because of the potential cardiac effects. Best.

NannaBaby

I am 3A  did adjuvant cisplatin due to unfavourable response to neoadjuvant chemo (AC+taxotere)