Discouraged and confused

Anonymous

Sorry for the double post...I posted on the chemo board and was redirected here...

I'm doing neoadjuvant - four AC followed by 12 Taxol-Herceptin-Perjeta. I have one more AC left and thought I was getting a good response. My oncologist has been measuring my tumor by hand and he said it has softened and shrunk by half. I can feel it shrinking and softening too. But today when I had an ultrasound and mammogram, the imaging showed no change in size!  I was devestated. I thought for sure it had shrunk. Are the imaging sometimes off? Is my onc mistaking the change in composition for shrinking? Has it started to regrow? Will I start to see more results when I start Herceptin? 

I'm Triple Positive, Grade 3

BlueFox

The person to give a definitive answer to these questions is your onc.  If you also have a Breast Care Nurse, like we do in the UK, you could phone her and ask her.

My layperson's understanding is that ultrasound measures the size of the tumour, but this does not necessarily reflect how many cancer cells are in it.  Tumour cellularity is the proportion of tumour cells to normal cells in the lump.  If it feels as if it is softening and shrinking, perhaps the cellularity has been significantly reduced?  

A net reduction in tumour cells is what you want to happen, whether by reducing the cellularity or by reducing the radius of the tumour or both.

TwinMamaHeather

Don't get discouraged just yet! For a lot of her2 people the taxol/herceptin/perjerta is way more effective than the AC as it is targeting those cells directly. Hang in there, this all sucks and it certainly sucks to feel like you are going through this for "nothing", but I imagine you will see more change when the targeted therapies start.

rozem

sometimes what you are feeling is scar tissue and not a tumor.  I could feel a hard ridge like area in the tumor area right up until surgery.  I thought for sure it was residual tumor but it was scar tissue and I had a complete pathological response after pathology.  Remember too that imaging is not always accurate at predicting size.  At my hospital they didn't even do any imaging during neo adjuvant for the reasons mentioned