Tripple negative (maybe) and pre-op

yeuker

Hi Everyone,

My wife was diagnosed December 23rd of last year. She is 37 years old, PR-, ER- and HER2 status is not yet known. We are scheduled for surgery on Wednesday of next week and are still unsure if she is HER2+ or triple Negative. Our surgeon has put in for the HER2 testing but we may not have the answer pre-op. If we were to find out she is triple negative, we could advocate for preadjuvent chemo. I.e. Chemo before surgery. Her tumor is approx 2cm and high grade. My question is this: If you were in her/our shoes, would you advocate for preadjuvent chemo then surgery or surgery then chemo 2 months later. We do not know anything else of her diagnosis like node+ or - to date. Any thoughts to help us think through our choices? We have found opinions and very small studies but nothing that I can consider significant enough to help make our decision. Any thoughts would be appreciated.

FYI: I have a similar thread that has carried me here in 'Just Diagnosed' that can be found here:

https://community.breastcancer.org/forum/5/topics/...

I am posting here to get the perspective of triple negative patients/survivors. Everyone has been awesome and helpful here and we really appreciate it.

Cory

BarredOwl

Bumping for input from triple-negative patients/survivors.

Mamiya

I would opt for neoadjuvant chemotherapy because that way you will know if it worked or not, and have options to try other drugs if one shows no response.

yeuker

Thanks for the reply Notdoneyet. As for others out there:

Many of you have or had tripple negative disease and were faced with treatment options. Could you share what considerations led you to personally to choose between neoadjuvant or adjuvant treatment, and to please indicate their age at diagnosis and estimated tumor size on biopsy. Neoadjuvant treatment for smaller tumors (2cm - ish) seems to be a newer practice and there does not seem to be large concensus on its practice.

We are on a bit of a timeline with Surgery scheduled Wednesday, a MO meeting on Tuesday and have some difficult choices to work through. Your experience is important to us.

Thanks again,

Cory

Angtee15

Hi Cory,

I'm very sorry to hear about your wife's diagnosis. I am Triple negative, with a 2cm grade 3 tumor. Very aggressive and was told it likely developed in the last six months. I am 43.

I started neoadjuvant chemo 28 days after diagnosis on 11/9/15. I fully expected to have surgery first, then chemo but that was before I knew I was triple negative.

I was told they wanted to do chemo first for a couple reasons--they didn't want to wait for me to recover from surgery to start chemo, and they wanted to see how my tumor would respond to chemo. I didn't have any node involvement, (based on the sentinel node biopsy), but the aggressiveness of the tumor made me feel like getting chemo asap was the way to go. Not that I was really offered a choice. I got the impression from the team that we needed to get moving on this.

Good luck!

yeuker

Hey Angtee. Thanks for the reply. From what we have read my wife is a decent candidate for per adjuvent chemo were she to be tripple negative. We really hope to have the results of her biopsy her2 prior to surgery. If she is indeed tripple negative and the MO is on board we will likely advocate for chemo first.

We would love to hear more advice from others on if they had the decision and what influenced them.

Thanks again everyone. We appreciate your advice and experience more than we can express in words.

Cory