72 year old Lady with 2cm lump TNBC- Have questions

Anonymous

72 year old Lady with 2cm lump TNBC- Have questions

exercise_guru

Hi Ladies.

I am hoping so much you gals can help me answer some questions. I am a 5 year survivor of HER2 breast Cancer so I have been here for 5 years but this new series of events have left me stumped.

Let me give you the stats and I am hoping that some ladies will jump in. Please please

My MIL is 72 and has colitis, and osteoporosis. She is on a special diet ( gluten free/low fodmap) diet and has a rotator cuff that gives her a lot of pain. She is thin and independently living in a home near her two sons ( I am 6 hours away but very close friends with her).

Two weeks ago she went for a mammogram and they found a small lump( 1.2-2cm) her nodes don't feel swollen but she had the lump for 2 months before she could get in because of Covid. It is Grade 3 and I am assuming Stage 1-above her nipple near the surface. Initially before the biopsy results they were suggesting she have a lumpectomy and then radiation. She meets with the MO and the Rad specialist Monday. Well today they told her it is triple negative. I am wondering what the course of treatment is "likely " they will recommend? They are right now thinking Lumpectomy and then I am assuming radiation and now assuming chemo but I don't know how the usual path of treatment for that.

She is totally willing to get a mastectomy if it means that she will avoid radiation or improve her outcome because she would rather just get on with life. Could she likely avoid radiation if she has a mastectomy? I just don't know how hard radiation would be on her because I had chemo and a mastectomy.

Also if they say she needs Chemo which chemo do they usually prescribe? I want to get an idea of what it would look like and I am not going to her appts with her as she has my SIL going but then I need some context to know what she is talking about.

wrenn

Hi, Sorry both you and your MIL have to deal with cancer.

I was diagnosed with TNBC grade 3 at age 66 (7 years ago). I was told that I could avoid radiation if I had a mastectomy.

They often prescribe adriamycin but because I have a family history or heart disease I chose to not have that. I only had one dose of the taxotere and cytoxan and was cut off due to complications. I am doing fine 7 years later.

Hopefully you will get the information about what to expect soon but I just wanted you to know that there are good outcomes.

ETA I was also told that lumpectomy would give the same odds as mastectomy but chose the mastectomy because of the radiation and because psychologically I wanted to be done with it. I had double because of large breasts and discomfort with single.

Caiti2067

My mom is 73, also has colitis, is very thin, and has osteopenia. Last year she had triple negative BC, and she was treated with AC + Taxol, Lumpectomy and 4 wks radiation. It was all unpleasant for her, neulasta was hardest, in so far as feeling really miserable, and keeping weight on was a struggle, but she's coming up on a year out from treatment and tired but ok.

I had triple positive the year before and I was told if your nodes are negative, lumpectomy + radiation = BMX but I don't know if they apply that to triple negative. My mom didn't want to get BMX surgery so we didn't ask. From reading posts here, AC + Taxol seems like the most common triple negative chemo.

Caiti2067

Wrenn, my mom also had metaplastic BC. Originally she was misdiagnosed with mucinous by rural area lab, 3 years ago, and had lumpectomy with no other treatment. It recurred locally 2.5 yrs later in the same place and this time we got a second opinion from Stanford and they said it was metaplastic. Anyway your story gives me a lot of hope for her.

exercise_guru

thanks for.your response..ehat order did she have the treatment? Did she do rads first? How.did she fair with rads?

MountainMia

Hi exercise guru. I am younger than your MIL, 58 when diagnosed 2 years ago and healthy/normal BMI, no digestive or other substantial health problems. My tumor was left breast, upper out quadrant, 1.5cm. I had lumpectomy, followed by chemo and radiation. I was prescribed taxotere and cytoxan originally but reacted to the taxotere. The alternate I was given was adriamycin and cytoxan, dose dense. I didn't follow up with taxol because of the taxotere reaction. The radiation was 16 whole breast and 4 targeted.

I think ACT is a pretty normal chemo prescription for stage 1 situations, and I wouldn't be surprised if that's what is recommended to MIL, too. It was not terrible for me, but I'm pretty sturdy in general. A lot of people talk about the Neulasta being the worst, but I had no trouble. Using Claritin supposedly helps with that, and I use it all the time for allergies. So maybe that's why I didn't have trouble with pain like many do.

I wish her well. I'm sorry you are so far away, as I know that can leave one feeling pretty helpless. My best to you both.

Caiti2067

She had her lumpectomy first, which I don't think is always recommended, then she had 4 infusions of AC spaced 2 weeks apart, then was supposed to be 12 weekly taxol and she only did 10, (it was getting really hard on her and we saw info that 10 is very close to as effective), then a couple of weeks to rest, then radiation. She did well with rads, it was tiring but she was not as generally yucky feeling as she was with the chemo. Rads were every weekday, but it was only about a 30 minute appointment and she drove herself (she was staying with me and I live 5 minutes from the cancer treatment center, really lucky in that way). In her experience rads were the 2nd easiest part (after surgery) - not bad at all.

Her colitis didn't seem to be made worse by any of the treatments. To top it all off she had an ablation for atrial fibrillation about 2 weeks after finishing radiation then I took her home to northern California the weekend before the Covid shutdown began. It was quiet a year.

Katiha

Hi!

my mom was diagnosed with triple negative stage 1 last May at the age of 68. She has lumpectomy, chemo and starting radiation in one week.

She had carboplatin and taxol as her chemo since she has arrhythmia. Chemo was hard on her especially the last two, but she managed it like a champ. She is getting stronger every day.

I wish your MIL all the luck and east treatment.

Hugs to you as well,

Kate

santabarbarian

My chemo for TNBC was taxotere and carboplatin.

Carboplatin is considered good for high grade TNBC. Not a horrible chemo as chemos go (only 6 x) I was able to deal with most SEs by fasting prior to chemo. Only the last two rounds were rough due to fatigue/anemia.

Carboplatin and Taxotere usual for Her2 (w HP).

(If they suggest chemo)

Lx + rads = Mx.

Remind her: lymphedema is no picnic... Mx not necessarily "no more issues."

But if she's thin, she is lower risk for lymphedema.

Trishyla

I think she may be considering mastectomy, Santabarbarian, so she doesn't have to have radiation, which can present huge issues for someone with osteoporosis. Besides, lymphedema is a risk mostly associated with removing nodes, which they will most likely do no matter which surgery she has. A mastectomy with no recon is not that big of a surgery. Many people stay just one night in the hospital.

Good luck, exercise guru. I hope she finds a course of treatment that she feels comfortable with.