What Kind of Chemo for Triple Negative

After two tests on my original biopsy that came back ER+ and PR+ and now two tests on my lumpectomy that have come back TN it looks like chemo is in my future. Sloan's pathology on my lumpectomy was TN and now I just back my Oncotype results. It came back TN with a score of 47.

I have an appt. with my Sloan oncologist next week to discuss treatment. Originally he said he would recommend the ACT course but now he is looking at some new study about CMF that says it may benefit TN just as well as ACT. Has anyone heard about this?

As for the chemo, either way, I'm concerned about the fatigue factor. And I'm very concerned about being susceptible to getting sick. I work in an elementary school (A hot bed of germs!). This CMF treatment is over 6 months. Will I be able to work? Will I ever feel like me again? I'm scared...

Hi all,

Great info in this thread.  My story:

Dx in January 08, see my info below.  Had lumpectomy with what my surgeon termed excellent margins, no node involvement, no known mets.  Had A/C chemo every 3 weeks X  4 doses. Then had 33 doses of radiation. Tolerated all very well.  Very ready to move on!

Recurrence:  Sadly, in Dec. 08 I found a new lump in same area as lumpectomy, after biopsy I got the dx in Jan. 09 that it was a true local recurrence, all the same markers as prior dx.  BS strongly recommended mastectomy.  I had a unilateral mast and tried for an immediate SGAP reconstruction, which failed due to poor vascular conditions in the flap.  

Started A/T chemo about 6 weeks after surgery, every 3 weeks X 4 doses and also 4 Neulasta shots, one after each chemo.  The Neulast was supposed to increase my white blood counts and help fight possible infection.  I did get an infection in my mastectomy site about a week after the first infusion, this delayed, by about 2 weeks, my second infusion.  The infected tissue didn't heal until well after I finished chemo :-(.  Before chemo I had  MRI on the remaining breast, bone, brain and abdominal scans all showing no suspicious activity.  

My onc apoloogized several times for not recommending Taxol the first time.  She explained that it's not usually the protocol with negative nodes and no mets.   

I have been NED since completion of chemo in August 09. 

Maybe not, kittycat. I've been doing chemo since mid February, and I still have thin fuzzy hair (I had a pixie cut). I always wear a hat or scarf out, because I look a bit like a baby chicken, but can't bring myself to actually shave it.

One doctor told me it might be genetics when I told him my Dad didn't lose all his hair when he got chemo for lung cancer. At the time, we thought it meant Dad's chemo wasn't working, but this oncologist told me there's no correlation between severity of SEs and the effectiveness of the chemo. Which is good, because I think mine has been a LOT less rough than I had feared it would be!

Hang in there, it'll be done before you know it.

Hi Everyone,

I start chemo next Friday. I will have a total of 8 treatments, one every two weeks. The first 4 will be adriamyicin & cytoxin and the last 4 will be taxol. I am pretty nervous about it and have been having anxiety come and go. I like to be prepared for things and like to have control of what I do with my life. TNBC has come into my life and taken that control from me and that is what has me all messed up.

I had the bilateral, in the process of getting fills in the tissue expanders (which suck! and hurt most of the time), I'm back at work, I did all the research I can do on wigs, hats, etc. to help myself be as normal as I can through this journey. Now let the battle begin!

I 2nd the "I will be bald in 3 weeks, wow!"  I too will shave my head, I bought 3 wigs in 3 different colors and will try to make the best of them.  So silly, hair is probably the least important thing in the world but it makes all of us feel so much better.

Good luck to all of you and God bless

As far as everything tasting bland, I found that citrus flavors come through great, along with mustard, vinegar, and pepper. If you can incorporate some of those in your food, it can really help with everything tasting like cardboard or tasting metallic.

Christi, you are my new hero!!!  How long were you on your chemo combo before you acchived (sp?) NED???  How many lung mets did you have?  I have been fighting TB mets (sternum and lymph nodes surrounding it) since November 2009.  I got 4 1/2 years before my cancer came back.  Anyway....I am currently on Abraxane, Gemzar and Avastin.  We are hoping to see NED at the next scan in two weeks and then take a break from chemo, but am really curious to know how long you have been on just avastin and zometa?  That was something that was suggested to us by the doctor we saw at the mayo clinic in rochester.  the abraxane is giving me some hard side effects and I am really tired of it....but am on a clinical trial with these 3 drugs so I can't just ask them to stop them all together!  Anyway....since reading your post, you have given me hope that NED can be achieved in TN!!!!  PM anytime.....would love to talk!!!

Cathi

Hi Kittykat,

I had TC chemo.    My Dr chose NOT to use Adriamycin because it is hard on the heart and can also cause leukemia.  My Surgeon in FL told me if I had a BMX I wouldn't need radiation.  Then becauase of the TN bit, "I" decided to go to Dr HJurvitz at UCLA Jonnsson Cancer center becauase of her special interest in TN.  Based on what they thought to be no nodes involved, and 1-3 cm cancer, stage I.  After Oct 7, 09 lumpectomy, 5/6 nodes involved and cancer over 5 cm now stage III.  Then did, 6 cycles of Chemo, then 5 mar. a mastectomy, am now starting 6th weerk of a 7 week course of radiation.  Then home to FL and to the Moffitt cancer center to have a mastectomy on right breast as I have a papillooma in that one plus I found a small BB size lump last Tuesday and tomorrow I will find out what that is!  What did your lump along the scar feel like?  My chest is now deep red, the way the radiologist likes to see it, means it is working.  Pretty itchy! NO tiredness yet.   For the next two weeks, they are concentrating on the scar, before that it was the drain area, and the area of the original cancer.  .My cancer grew FAST.  From Aug 25th 1 cm to over 5 cm by Oct 7.  My advice is MOVE FAST with TN, and do anything you can to fight it.

I had Taxotere and cytoxan, every 3 weeks, three times following my lumpectomy, and prior to my mastectomy. Then after I had my bilateral mast, I was given another 2 rounds of TC. I did have a bad reaction to the Nuelasta, each time got worse. After my forth injection, I wound up in the ER, so it had to be discontinued for my next infusement.

My onc would not give me adriamycin, fearing heart problems

Sorry to hear your chemo was put off - once you've got it in your mind to start you're ready.....  I didn't have an MRI with my port, but I did have an MRI recently and saw a notation on the form that said to notify the tech if you have a port.  I'm guessing they can work around it.

I had taxotere and gemzar x 4 then adramycin and cytoxan x 4. Had complete reaction with no trace of initial tumor but did have in another area dcis.  but waiting to see if i have recurrence now. soild mass in left axilla biopsy monday.

After an appt with my onc at Sloan on LI and then a second opinion appt at LIJ/North Shore it looks like I am going with AC-T. That was the first choice for both oncs. My onc at Sloan's second choice was CMF but he really thought AC-T was better. The secondopinion onc practically begged me not to do CMF and thought that was just the wrong thing to do.

 I never even thought I was going to need chemo in the beginning, with Stage 1 and no nodes! Got my Oncotype back and it was high. So here we go. I was hoping to do the CMF since its milder but I've decided I should go with what they both really agreed is the best. I am scheduled for the Mugascan on Friday morning. Hopefully that will go OK. I just recently (the month before the BC)was diagnosed with VERY high blood pressure. I'm on BP meds now and its totally under control but I'm concerned with the heart issue on Adriamycin. And the second opinion dr. did mention the leukemia thing. Hope I'm making the right choice. Trying to figure out the wig thing now too. Will go read those boards for advice!