Triple Negative IDC

Hopeful_Husband

Hello, I am new here, looking for ways to support my wife by helping her get the information she needs to make the best decision she can about her treatment plan.

She was diagnosed with triple negative insitu breast cancer 10/20/17, she had a lumpectomy and sentinel lymph node removal 11/27/17. She is still in pain, limited range of motion in her right arm.

Her margins are clear, lymph nodes not affected, tumor is 1.5 centimeters

Stage 1, grade 3, we met with the medical oncologist yesterday, who is recommending 6 rounds of chemo using The strongest available. He wants her to start ASAP. We are scheduled to meet with the radiation oncologist 12/28/17. We asked about the OncotypeDX score, and were told that it was not relevant to her case.

She is being treated by Kaiser in California. We are overwhelmed by information and everything feels a rushed.

The logic for chemotherapy is:

If 100 women have her type of cancer 73 will live another 10 years(she is 60). The 27 that die in ten years will die of all causes, not only cancer. The oncologist thinks that chemo could save 4 more lives.

The math kills me! But isn't it a less tha 4% chance that the treatment will save her life?

What am I missing? Thanks.

Wooki

Hi Hopeful Husband

Your wife’s dx and stage is the same as mine. I had my lumpectomy and I am now in chemo.

The maths sound right - I’m 55 and the 10 year benefit for chemo for me was 6%. My Onc advised that he advised chemo if benefit 3% or over. You may want to have a look at the Predict website and enter your wife’s data into that. As TNBC is aggressive and there are no other therapies - chemo is always recommended by the professionals. There are plenty of threads on this site and other sites re: pros and cons of chemo for TNBC and they may help you come to some conclusion but I decided I wanted to max my chances and even if it meant suffering chemo for a reactively low % outcome improvement.

I have found the fear of chemo worse than the reality and there are things you can do to mitigate risks and make your wife’s chemo journey easier and loads of advise on this forum. My last cycle was on 22nd Dec - not the best way to spend Christmas but I managed a decent Christmas dinner yesterday! Back in bed the rest of the time

The rush is associated with outcomes - obviously the sooner chemo starts post surgical recovery the better the outcome - optimum target is 31 days post surgery. The range is 4-6 weeks ideally although some start later depending on individual circumstances and surgical recovery. I pushed hard to start mine ASAP post surgery and started after 39 days.

I am on TC as I have minor heart issues. I’m guessing that your wife is being recommended AC-T which is the standard first line chemo defence for TNBC in the US.

All the best to you and your wife. It is a crap hand we have been dealt - we just have to pray we will come through this and there are lots of positive stories on this forum too.

Best wishes Wooki

XXXGGGYYY

Dear HH: I was triple negative, stage 1, grade 3; tumor size of 4 cm. The surgeon removed my breast and 2 sentinel nodes. Everything came back clear. In my case, the oncologist declared me done with treatments -- no chemo needed or recommended. She said chemo would be a disservice to me. I'm age 50, pre-menopausal. I went to one of the finest and most famous medical facilities in the world. Of course, your wife's situation could be quite different from mine.

KSteve

Hopeful husband - Triple negative is a little different in that it tends to move quickly. The chemo is the insurance policy to kill any cells that may have moved from her breast but aren't large enough to be seen. It is definitely a more time sensitive type of breast cancer because of the speed at which it can grow. I found the chemo to be very doable and continued working throughout the treatments. I had chemo every other week on Thursdays, so I took that day and the Friday after off, but worked the rest of it. Everyone is different, but the main thing is, ask questions. Make sure your wife (and you) are comfortable with the direction treatment is going. And lastly, be happy that they are moving fast. Less time for any potential cells to "set up shop" elsewhere (as my oncologist used to say!).

Hugs,

Kathy

Hopeful_Husband

Thanks Wooki. I used the predict tool and it says 82 out of 100 live 10 years with no chemo. With chemo another 4.

Kathy and XXXGGGYYY thank for helping my understanding.