Oncologist said no chemo needed !( confused )

Calvin71

I had my pathology reports yesterday and the surgeon told me due to the size of the mass which is 7 mm and it has not gone to my lymph nodes that I will not be needing chemo and just only surgery. I am puzzled because it is triple negative. Did anyone experience this ? I have a second opinion tomorrow.

jhl

Calvin,

Are you seeking this out for your wife Bikegal? You write in the first person but from previous comments, the individual with cancer is your wife. Is that correct? This is a question that cannot be answered unless we have more information. By any chance, is English your first language?

Calvin71

Wife ? This questions is for me .I’m a female . I’m totally puzzled by this entire message . Yes I speak English . It’s my first language .

jhl

Calvin,

I so apologize. From a previous thread, it appeared you were speaking on another's behalf. I was confused.

Can you be more specific about your pathology? Hormone receptor signaling, HER + or -? Stage and Grade of surgical pathology? Could you give us more to go on?

Again, I do so apologize,

Jane

Beesie

Calvin, here are the current NCCN guidelines for triple negative. For a 7mm tumor, it says to "consider chemo" but chemo is not firmly recommended in all cases, as it for tumors over 1cm in size.

How old are you? If you are older, that could be the reason for the "no chemo" recommendation, if you see footnote cc.

Cowgirl13

Definitely see an oncologist. Chemo is not the purview of a surgeon.

Calvin71

Hi . I am 57. It’s triple negative on my good breast as I had TN on my other breast in 2012. Grade 3.

Calvin71

it’s ok ! So far stage 1, triple negative , 7mm tumor . Grade 3. No nodes seem to be involved . No lymphovascular invasion .

jhl

Hi again Calvin,

Have you been referred to a medical oncologist (MO)? I agree with Cowgirl, a surgeon is not the decision maker on who does or does not need chemo. Have you followed the NCCN guidelines? https://www.nccn.org/patients/guidelines/content/P...

Calvin71

it's ok ! So far stage 1, triple negative , 7mm tumor . Grade 3. No nodes seem to be involved . No lymphovascular invasion . Tubuld

Calvin71

Tomorrow I meet with other team of doctors that I have personally chosen . Oncologist, surgeon and plastic surgeon . Totally different hospital . I chose them each based on their background 2 are formally from Hopkins . Let’s see what they have to say and their plan

Calvin71

thank you !

jhl

Calvin,

Thank you! If you are meeting with Hopkin's cancer physicians, they are at a NCCN hospital so they are very up to date on the latest research. This is a tough time with more questions than answers. I'd encourage you to read, particularly folks who have a similar kind of pathology. Read & write down your questions. Ask lots of questions. Is there anyone who can go with you to your second opinion who can take notes while you try to absorb the info you are being given. You should be able to access your clinical information online - that is a new law as of 2021. However, if you feel you cannot find it, be sure to ask for a paper copy of your pathology, surgical record & recommendations.

Best of luck tomorrow,

Jane

ShetlandPony

You are fairly young, it is grade 3, and this is your second breast cancer. I would not be surprised if the medical oncologist is in favor of chemo. It's great that you have a team to meet with tomorrow.

(By the way, since we don't have a reply function that links to a specific post, if you like you can just talk to everyone in the same post, like a group conversation.)

Calvin71

Thank you everyone I’ll let you know what they say .

LIgma

Hi Calvin,

First time chiming in on the boards but maybe my story will help. Diagnosed 01/20 with TNBC. 1.1 cm total mass (5mm of DCIS and 6mm of IDC). No lymph nodes and no lvi. Was told only the IDC gets consideration for treatment. There was never a question about having chemo. I go Msk and was told from the get go I was having chemo. Had CMF due to the fact I already have some neuropathy in my feet and MO did not want to leave me in a bad way (his words). The Taxines could make it worse. I do not regret it one bit. Good luck today. Hope this helped.

Calvin71

Thank you . I went to Sloan in 2000. I had Cmf then . Hoping I’m able to get it again since it’s the other breast . Just sent message to my oncologist from back then for her input .

2019whatayear

Calvin71 had you had genetic testing done? TNBC in your 30s and then back in the other breast in your 50s could mean a potential genetic mutation. Hope you have/had a good appt. Sorry you are dealing w/BC again

Calvin71

yes waiting on results any day but I was negative for Brac 1 and 2 in 2002

ARmom4

I only had 3mm invasive and I had chemo. After consulting with Mayo clinic my MO recommended it. I was triple positive though.

Calvin71

I’m Brac 1 positive. Found out yesterday. My tumor was 1.3cm and clear nodes and margins . Chemo soon and who knows what else . I have 3 top doctors I’m consulting with but will of course probably go with my Sloan Kettering one as she has access and knowledge to the best treatments and most up to date . She has also 40 years there .

TurboKitten88

If it were me i would want it! I wanted to throw the whole kitchen sink at it. Mine was larger also so there was never a discussion. But if needed i would say get a second opinion!<3

ShetlandPony

It is really good that you got the more current BRCA testing, as your positive results can influence treatment. Well done seeking second opinions including MSKCC. Everything taken together (and I see the tumor size was upgraded), it makes sense to do chemo. Go for it, Calvin! Take your opportunity to blast this cancer. Wishing you well.