Local recurrence while on chemotherapy

Anonymous

Local recurrence while on chemotherapy

Passant1

Hello,

I was diagnosed oct’17, had a lumpectomy with clear margins, no node involvement, started chemo on dec’17 and the plan was 3AC+9T. Which i was almost half way through with them.

I was just diagnosed with local recurrence, 3 masses same location, which drs thought was previously fat necrosis.

How can new masses develop while on chemo? What are the second line drugs?

Thanks

Momchichi

I did not have a recurrence on chemo but my cancer continued to spread to more lymph nodes while on neoadjuvant Taxol. I was originally diagnosed triple negative but after surgery, some of my lymph nodes were HER2 positive (my breast mass remained triple negative). My surgeon was surprised and said "it must have just grew and grew on Taxol." The MO told me it could have been a "survival of the fittest situation" between my triple negative cancer responding to chemo and the HER2 positive then flourishing. Neither doc's answer really gave me much confidence that my cancer would respond to treatment but I am now on a different chemo protocol adjuvantly for the HER2+. Could this be the case with you? Did you have testing to confirm the new masses have the same receptors? I know Xeloda is offered for residual disease after initial chemo/surgery but I'm not sure about a local recurrence. I am so sorry you are facing this, I know how frustrating and hopeless it feels to have chemo not work. I hope your team develops a new treatment plan for you quickly.

KBeee

Sorry you are dealing with this. Did they go MRI beforehand to confirm there were no other tumors?

Do have them check the hormonal status and HER2 status of these.Hoping they can order advanced genetic testing on the tumors to see what chemo they will respond to.

Keep us posted.

jo6359

if you were receiving chemo how were the new tumors discovered?

buttonsmachine

I'm really sorry you are going through this. I had a somewhat similar situation, which I will share with you in case my experience can help you avert some of what I ended up dealing with.

I had a lumpectomy with clear margins and negative nodes, and then I noticed a small lump while on TC chemo. The doctors said it was fat necrosis, and I trusted them. Long story short, the "fat necrosis" grew, was finally biopsied, and then was confirmed to be my original cancer. In my case the cancer came back between the initial biopsy scar and the lumpectomy scar. My new doctors thought I had needle track seeding - which basically means the biopsy needle dragged cancer cells through my breast. While some stray cells *should* have died due to lack of blood supply, chemo, and radiation, my cancer survived and even GREW despite all these things.

Unfortunately, some cancers can grow through active treatment. Mine did, and I basically had to start treatment all over again: I had to have more surgeries, AC and Xeloda chemo, and another course of radiation.

There are a few things I have learned going down this really bad road:

1.) Before you do any more surgery, please, PLEASE make sure your doctors order a breast MRI for you. This was not done before my mastectomy, and then I ended up needing a chest wall resection because they STILL missed cancer cells.

2.) Your doctor should also order a PET scan to check for distant disease before surgery - this way will you will not undergo a possibly unnecessary mastectomy.

3.) My final word of advice is to make sure you have expert doctors now that your case is more complicated. My original doctors were supposedly good in my area, but they could not adequately deal with my more complex case. Because of this I lost valuable time while they went in circles, and I ended up suffering a lot more treatment than if things had been done correctly the first time. I am at an NCI designated cancer hospital now, and I wish I had come sooner.

Feel free to PM me if you need to. Best wishes to you and please keep us posted.

Passant1

hi Pre-K79 the new masses are actually TNBC it resisted taxol and grew. they came up with a treatment plan that keeps changing based on the situation but my chemo protocol is the same (Carbo+Gem) they added avastin for 3 sessions and then replaced it with tecentriq.

Hi KBee yes i did a pet scan and MRI post surgery and they were clear, unfortunately advanced genetic testing isnt accessible here, i did the BRCA 1 & 2 and they came back -ve.

Hi jo6359 they thought that this was fat necrosis/edema after my lumpectomy, i felt that its growing so i went and got an ultrasound even though they didnt indicate it, the radiologist asked for MRI so i went to my surgeon who told me right away that it is indeed a local recurrence.

Hi buttonsmach... i cant believe how similar our stories are, they thought that it is Fat necrosis as well, so it kept growing for a month and half before i went ahead with the ultrasound and my surgeon confirm that it is a recurrence even before the biopsy, it had the same properties as my original cancer. 1. i believe i will be doing that right before the surgery 2. already done even before getting the biopsy results, my surgeon was so sure that he sent me for a pet scan anyway. im on Carbo+Gem and should be having surgery within 6 weeks.

jo6359

passant- I hope they find the right chemo medications which will work for you. That Really sucks. What a tough sutuation to be in. Its good you were proactive. Best of luck to you

rdeesides

I didn’t have recurrence while on chemo, but I had no response to chemo (my tumor actually grew on Taxol). I think there is a subset of TNs who are resistant to Taxanes. Gemzar/Carbo is the standard second line of treatment from what I have seen so I think you are doing the right things