Completed Neoadjuvant chemo, still positive lymph nodes
I recently completed dose dense neoadjuvant chemo (4AC-4T), had a double mast, and the pathology reports came back with two positive lymph nodes. Has this happened to anyone else? Do I need more chemo? How do I know if my onc is doing enough?
Comments
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I am sorry, I don't have answers for you and I am not sure how many are on line this late at night.
Did the chemo shrink your tumor? I was diagnosed with IDC, 4CM - did the exact same chemo regimen and my tumor shrunk down to where they couldn't even feel it but that was when I was 6 weeks out of chemo.
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The chemo shrunk the tumors from 2.5 cm to .8 cm and 2.1 cm to .9 cm. I had two tumors connected like a barbell.
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Hi there,
Please don't be discouraged, there are a few woman on the board who completed chemo first and had positive nodes still. It is actually quite common.
The chemo tends to attack the big bulk tumors first. It's called "tumor load". Good news is that it shrunk those tumors real good. A complete pathological response, no cancer left at all, is rare. Especially, with ER+ woman....around 20% of woman have a complete response.
As for more chemo, your onc may or may not suggest it. You are ER+ so anti hormone meds will take care of stuff. You will also most likely have rads too.
Hang in there....you still have a lot of arsenal to fight with.
Be well.
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I echo Lexis' thoughts - hang on in there and good luck.
xxxxxxx
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I echo Lexis' thoughts - hang on in there and good luck.
xxxxxxx
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Thank you for the replies. I am trying to stay positive, and am still struggling. I fear that I won't see my children grow up. I have a 5 month old and a 19 month old. If there are survivors out there who had positive nodes please respond and give me hope.
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So sorry. My heart aches for you and your little ones. I'm just appalled at the number of young women developing this disease. Something is seriously wrong in our environment.
When is your next meeting with your onc? Bumping you up the thread so someone with a similar experience can share their success story.
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I am meeting with my onc in two weeks. He originally told me that we would move to radiation and then when that is completed we will start hormone therapy. I am now interested in starting hormone therapy earlier.
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39mom2babies ~ I just wanted to tell you that there are many women within these discussion boards who had a lot more positive nodes than you have, had treatment, and are doing great years after their diagnosis. I know, in the beginning, we all get overly focused on statistics. But keep in mind that treatment is constantly improving; even neoadjuvant chemo is something quite new. 3 positive nodes, while more concerning than if you hadn't had any positive nodes, are absolutely no reason for doom and gloom thinking.
That said, it never hurts to get a second opinion, just to be sure that what you're doing or want to do is the very best treatment option for you. If you have any doubts about what's planned for you, by all means make an appointment with another medical team to review your records and weigh in on what else you still need to do. You can stick with your current team if you're happy with them, but a second opinion may give you that added peace of mind (about the positive nodes, when to start hormone therapy, etc.) it sounds like you could use.
Take care ~ Deanna
P.S. Your babies are adorable!
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I'm right there with you on this one. Just has the boobs removed 2 weeks ago right after 6 chemo treatments with TAC. 11 positive lymp nodes with surrounding tissue involvement. I was/am still scared shitless!! I have 2 girls - 3 & 6 years old that I want to watch grow up but the doubts have been setting in.
My onc said that he definately recommends more chemo for this type of cancer (IBC or IDC depending on what dr I'm talking to at the time) especially since the first kind of chemo did not kill it completley. He is recommending the next chemo combo to include - Cisplatin / Taxol/ Epirubcin. I have already scheduled a second opinion appt in Philly, PA because well as I said before I'm scared shitless and need to know this next round will work.
Obviously, I'm not the best person for the positive support but I'd love to talk to you through this all. Email me any time day or night - I'm homebound now and have too much time to think about all this.
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Dear MossyBaby,
Sending positive thoughts your way.....
Have you joined www.tnbcfoundation.org? It is a community of women with the kind of cancer you have, i.e. ER-, PR-, HER2- and you may find information there that is not readily available elsewhere.
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39 and momto 2 babies,
Hang in there. I had a 4 cm tumour, diagnosed at age 41 and 3 positive lymph nodes. It is possible to live a long and healthy life with positive lymph nodes. I did not have chemo prior to surgery but had mine after my lumpectomy, followed by six weeks of radiation. I also had my ovaries removed and am on Armidex for 3 1/2 years.
Having your tumours shrink while on chemo is good. You may want to ask your oncologist his recommendations on whether more chemo is needed, get a second opinion if you dont feel comfortable with his answer. We have to be our own advocates sometimes, I have learned this along the way as doctors can be so busy and preoccupied with their large case loads.
The hormonals work well too for er+ breast cancer.
Your babies are gorgeous!
All the best...
Michele
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39mom2babies - Hello, I had neoadjuvant Chemo for 6 months, my tumor was my entire breast by the time I went thru all my tests and was ready for Chemo. I had two positive nodes. By the time I finished Chemo and had my surgery there was no palpable tumor, only a smattering of cells. There were still 2 positive nodes and the other nodes were full of scar tissue. My Onc didn't think i needed more Chemo and research I did confirmed that. As I was Her2 positive I finished a year of that and will be on AI's for 5 years.
I have meet 2 women with no nodes who have had a recurrence and those with 13 nodes live for years. So don't assume you will not see those beautiful little ones not grow up! Do all you can to stack the cards in your favor. Exercise, eat healthy with lots of fruits and Veggies, whole grains, take antioxidants, etc...... Do some research and find out what you CAN do. You are welcome to PM me if you would like.
If it would make you feel better to get a second opinion do that, that is something you CAN do.
Best of luck to you and your sweet little ones!
Susie
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Hi Mossybaby, Id be happy to talk to you anytime. I am also homebound, recovering from a double mast. My mom is here helping with the kids. The only thing, Im new to writing on this site and dont know how to e-mail you directly. I hope you read this.
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Thank you SusieMTN, I am trying to do the research and am coming up with the same results that most do not continue chemo if you finished. I now want to research what the hormone therapy can do. Did you do a sentinal node biopsy to find the original 2 positive nodes? or were they discovered by scans?
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Thank you Curly locks. Your tumor type is similar to mine. I know every person is different, but it helps to see people with similar diagnosis that are beating this disease. this help to feel more positive because it seems possible. Thank you!
by the way, I see that you stated you are a Canadian gal. Where about? Although I live in the states, we have a place in Kingsville, Ontario
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Bumping fr or success stories!
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39mom2babies - No my positive nodes were found on either CT or MRI i forget which one, but when I went in for surgery they also found the 2 nodes still showing cancer, but like i said the rest of the nodes where all full of scar tissue, scarey in itself that it can so that to lymph nodes and not to veins! I never had an Sentinal node biopsy, it was straight into Chemo. My cancer grew at an alarming rate and I am sure the thought was get her into "CHEMO FAST"
I believe my Onc told me that "hormone therapy" improves your chances my 14% but I can't be sure, read, talked to too many people and web sites! I just want to be one of the 14% or whatever percentage it is! Goodnight ladies
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39Mom - post this on the Stage 3 forum.....there are loads of women there who had +'ve nodes after Chemo and are fine, 5 or more years out....hang in there.
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39mom sis has similar story - large ER/PR+ tumor HER- Had presurgical chemo (4 AC's & 12 Taxols) and her unilateral mastectomy was 2 and 1/2 weeks ago. She had neg sentinel nodes but over 1/2 other nodes positive (double digits). Look at the report - hers said marked treatment response - doc said they have to say + node even if a speck of active tumor is there. No more chemo! She will do rads then Tamoxifen - doc said Tanoxifen is the strongest weapon in the arsenal (more than the surgery, chemo, rads) for hormone positive tumors - so no worries. Good luck! Breathe!
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Hi. I know this is an old thread, but I just heard that I had 8 positive nodes despite 16 weeks of dose dense chemo and surgery. Is anyone available to chat?
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Hi sayitaintso, I just checked the site and saw your response. I originally started this thread in 2009 and will be 5 years out in May. So far still NED. I hope you get other responses. I know success stories help a lot. Hang in there. The cancer is out. There are women who had as many lymph nodes from my time frame who are still here doing well.
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by the way, that little girl in my picture will be in kindergarten this fall had her brother will b a first grader. This is doable.
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I'm also having Neoadjuvant.... a question on how your breast did or did not change. I've had #7 Taxol then will do 4 AC. Breast is still hard, swollen and red/blue. Some of this is from the biopsy, mri, mammo... had US and looked good on the inside but outside not so great.... Any thoughts would be appreciated. -
I also had neoadjuvant chemo with positive nodes after surgery. Please feel free to pm me.
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IHi all, this thread has been quiet for awhile but I just finished neoadjuvant tx end of July and had a BMX on Aug 7. She removed 11 nodes and 10 were positive. I'm assuming AI's and rads but I can't get in till Aug 26. Any words of wisdom out there?
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Being er and pr positive what about tamoxifen, you may have good results with them press your oncodx. They might work better than the chemo. Praying for you.
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39mom2babies, I know this thread is old but your question prompted my question. I also had neoadjuvant chemo, AC and Taxol , 16 weeks, from April thru September 01, 2016; had left breast US and mammogram in 08/23 and tumor shrunk but not much. I would presume the US show if my axillary lymph nodes inflamed or not. But the BS didn't say anything about lymph nodes. During my unilateral mastectomy 10/5/16, BS took out 3 sentinel lymph nodes and pathology show positive margin on tumor but negative lymph nodes. Could this be false positive? Did you have another surgery to get rid of your positive nodes? What was your treatment? Thanks for any inputs.
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I was diagnosed in September. Was told to do chemo first and decided against it. Getting surgery November 9! I hope I made the right decision. Did they say you would get a Full response? I was told it would be downstaged But that er tumors don't get a full response. I believe the tamoxifen will be the thing that helps us hormone receptor positive women. They said overall outcome is same. And becsue you have positive nodes doesn't mean it didn't work.
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I just happened to check today for some reason. I saw your post. My nodes were found because removal from surgery. No other surgeries after. I am now almost 8 years out. Still doing ok.
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