Triple Negative Breast Cancer | Treatment Options

PGulatee

My wife (32 years old) had been diagnosed with Breast Cancer in the month of March, there have been 2 surgeries that have been conducted since then, the first being the BCS where the tumor was removed. After the surgery there was a report that stated that one of her non sentinel lymph nodes was tested positive where as the other nodes removed for similar test were negative. The doctor advised a second surgery to remove all the lymph nodes, fortunately no other lymph node was positive. After we got a report which stated the type of cancer and it came out as Triple Negative, Grade III.
After this she underwent chemotherapy, The Medical Oncologist prescribed
TAC*6 cycles, every 3 weeks + 25 days of radiation followed by 7 days of Booster radiation.
She has recently undergone her 6th cycle. Her chemo cycles were tough and most of the times she had fever, nausea, weakness in the first 10 days after the chemo. Only in the 5 cycle she had high fever on the 18th day owing to which her 6th cycle got postponed by 10 days.
Our biggest worry till date has been the relapse of the cancer as what we have heard and read is that triple negative cancer is a highly agressive cancer and is likely to come back.
My question is, should there be some other treatment that she should go after radiation which can reduce the chances of relapse. I have read of PARP inhibitors and another study on breast cancer stem cells which cuts of the cancer cells from the blood vessels [http://www.myhealthnewsdaily.com/breast-cancer-stem-cell-drug-1566/] (Pardon me for my lack of knowledge if what I stated was distoted).
We would take any medication or treatment if it reduces the chances of recurrences even if it is reduced by the slightest of percentages.

Request you to please help me.

Thanks,
P Gulatee
New Delhi, India

TifJ

Unforntunately there is no follow up medication for triple negative as the only current drugs out there for follow up target hormone receptor positive cancer. You did not mention your wife's stage. That may determine whether a PARP trial would be good for her. I am stage 1 and have not been offered any PARP trials nor does my doctor order any scans after treatment unless symptons warrant one. My breast surgeon sees me every 4 months and my oncologist sees me every 3 months and I have blood work done to test tumor markers. It seems those of us with triple negative are just kind of thrown back out into the world and we are left to worry about an recurrence.

I'm sure some other triple negatives will respond here soon. I wish you and your wife the best!

Luah

While it's natural to worry, please be assured that TN is not "likely to recur." While risk of recurrence is higher in the first 3 years for TN (than for other types of BC), it declines dramatically beyond year 5. Prognosis depends on stage, and it sounds like your wife, with one affected node (like me)  would be considered early stage. PARPs and other drugs in development probably wouldn't apply, but be sure to ask your oncologist for any clinical trials that might. 

My oncologist said chemo would likely cut my risk of recurrence (which was 50-60% following surgery) by half. I maintain a healthy diet and exercise a lot, which is supposed to cut risk by another 50%. I'll take those odds, but at the end of the day it's a binary calculation: you either get it again 100% or you don't 0%. Wish you and your wife well.