Triple negative research papers

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BrandyB
BrandyB Member Posts: 195
edited June 2014 in Triple-Negative Breast Cancer

I was DX Nov. 2009 wi TNBC, 4 small tumors, several very small spots of cancer throughout my breast, and 2 pos lymph nodes. I am being treated at MD Anderson Cancer Center in Houston, TX.  I received 12 doses of weekly Taxol and 4 doses of FAC.  I had a unilateral mastectomy May 28th and there is no evidence of disease at this time.  My doctor was explaining to me that if TN breast cancer patients achieve full pathologic response then the relapse rate is 3-4%, meaning 95-96% long term survival!  In 2 weeks, I move to Houston to receive 6 wks radiation, then surgery to reconstruct.

He sent me some scientific papers that back up this information.  I'd like to share these papers with everyone here.  I find it very interesting and encouraging. Does anyone know how to attach files?  If I can figure that out then I can share.

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  • chinablue
    chinablue Member Posts: 545
    edited June 2010

    What is a full pathologic response?  I would love to read this very encouraging news.

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  • BrandyB
    BrandyB Member Posts: 195
    edited June 2010

    Full pathologic response means that the pathologists did not find any cancer in the tissue that was removed during surgery.  I had a skin sparring mastectomy and 27 lymph nodes removed.  As it was explained to me by my surgeon, the pathologist cuts the tissue into slices, then X-rays the slices to identify suspicious areas, then makes slides of those areas and examines then under a microscope.  They then work through each lymph node and search for cancer.  If they do all of that and see no cancer, then you are in full pathologic remission.

    PM me your email address and I'll email you the papers.  I can't figure out how to attach the  files to these posts. 

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  • Luah
    Luah Member Posts: 1,541
    edited June 2010

    When I want to attach a research study, I first copy the URL, then paste it into the body of my message here.  Hope it works.

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  • jenweg
    jenweg Member Posts: 195
    edited June 2010

    Wow this sounds awesome, however what if you have surgery first, then chemo??

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  • fightinhrd123
    fightinhrd123 Member Posts: 633
    edited June 2010

    My trial Dr is doing a small study on this and he said the exact same thing.  Out of 149 CPR only 4 relapses in seven years.  (those arent exact, but close)  He's planning on publishing it soon.  Only he included ALL CPR, not just triple neg :)  And yes it would be cancer free after chemo, before surgery

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  • BrandyB
    BrandyB Member Posts: 195
    edited June 2010

    These studies are files that were emailed to me, so there is no link to them on the web.  The studies included women who were treated with chemo before surgery.  I don't believe that it matters which you do first, chemo or surgery.  However, if you do chemo 1st, you can know what affect if any chemo had on your cancer.  If they can see that the chemo killed your cancer It is another way to predict your prognosis.

    My doctor actually told me that there is no data to suggest which is better - chemo then surgery or surgery then chemo.  I just did what they told me to do...  Which was chemo 1st

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  • workmother
    workmother Member Posts: 78
    edited June 2010

    I'm liking this report you found. I had a lumpectomy, no nodes were involved and they got clear margins first time. I have a high Oncotype score so I'm starting aggressive chemo next week. All the stats show me as a 30% chance of recurrence with no chemo and it cuts to 15% with chemo. From what you posted here I think I would fall into the full pathological response. I like your odds better!!

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  • thenewme
    thenewme Member Posts: 1,611
    edited June 2010

    Hi Brandy,

    Congrats on your NED status - wooohooooo!!!!  It sounds like your prognosis is great!  I'm not sure that a relapse rate of 3-4% for TNBC after PCR would be standard across the board, though - there are individual factors that likely would make that prognosis variable.  For instance, it doesn't account for things like stage, node status, LVI status, treatment specifics, etc.   That said, 3-4% relapse rate sounds pretty good to me, so I'm anxious to read more about it!

    I'm not sure if you can attach a file, but you should be able to find the research online and then just link to it here instead.  Or just post more details of the research (title, author, key words, etc) and maybe we can help find it.  Thanks for sharing!

    Maybe it's one of these?:

    http://clincancerres.aacrjournals.org/content/13/8/2329.full 

    http://www.jco.ascopubs.org/cgi/content/full/26/8/1275 

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  • BrandyB
    BrandyB Member Posts: 195
    edited June 2010

    It is indeed this article http://jco.ascopubs.org/cgi/content/full/26/8/1275 

    The article address the fact that several different factors affect your chances of having complete pathologic response.  Factors such as age at diagnosis, tumor grade, race, ductal vs non-ductal, etc.  However, the goal of the study was to determine how reaching cPR affects long term prognosis.

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  • thenewme
    thenewme Member Posts: 1,611
    edited June 2010

    Aha, I see what you mean now!  The prognosis in general is likely even better now, since the article points out that a lot of the patients in the study were treated with anthracycline-only regimen without a taxane.  The taxanes have been shown to increase pCR rates in general, so that's good news!

    Brandy, thanks for sharing!  I've read this article many times but each time I re-read it, something else seems to  jump out at me.

    Again, big congrats for the pCR/NED status - that's awesome, and what a relief!! 

    I had adjuvant chemo rather than neoadjuvant, so I don't really have the pCR reassurance.  I wonder what the relative numbers are for neoadjuvant vs adjuvant chemo specifically for TNBC - does anyone know?  It seems like I'm hearing more and more of us are having neoadjuvant, so hopefully that's a good trend to help measure pCR and give more clues TNBC and give some balance to the prognosis fear!

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  • willy2351
    willy2351 Member Posts: 5
    edited June 2010

    Thanks very much, Brandy, for your post and the linked article.  It was very helpful, despite being a bit since my wife falls into the worst category. 

     In the articles provided to you, is there any article/study that uses this type of analysis but distinguishes between residual disease just in the breast and residual disease in the breast and in the lymph nodes?  If you or anyone else knows of such an article/study, we would really appreciate seeing it.

     Thanks, again.  And we are very glad for you that the chemo worked so well for you.  That is great!

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  • BrandyB
    BrandyB Member Posts: 195
    edited June 2010

    willy,

    I'm sorry, this is all I know.  I didn't have the courage to read studies like this until just recently.  I didn't want to hear any statistics at all!!  At the end of the day I remind myself that I'm either 100% alive or 100%not alive.  There is no such thing as being 62% alive or 40% alive, so numbers and statistics don't mean anything to an individual.  In fact, if statistics offered any sort of protection, I wouldn't have breast cancer to begin with.  I have no family history, I'm only 36 so I'm sure that my risk of developing breast cancer in the first place was probably negligable... However, I have breast cancer. 

     So I tell myself, if I was "lucky" enough to fall into the 2% of women who fit my description and still get breast cancer, then I have every right and opportunity to fall into the LUCKY group of women who survive, however small or large the odds may be.

    I know that that didn't answer any questions for you, but I just wanted to share my thoughts.  Hope some of it helped.

    Brandy

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  • thenewme
    thenewme Member Posts: 1,611
    edited June 2010

    Well said, Brandy!

    Willy, am I remembering correctly that your wife had neoadjuvant chemo and then a bilateral mastectomy recently?  How is she doing?  Is her residual cancer burden confirmed by biopsy or scans?  Did they do complete node dissection?  Will she (or has she) done any radiation therapy?  I know I've seen some statistics on prognosis for TNBC with regard to node status - I'll look for it.

    Best to you, Willy, and your wife!

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  • willy2351
    willy2351 Member Posts: 5
    edited June 2010

    Yes, newme, you are remembering correctly.  Thanks for asking about my wife.  She is doing okay: fabulous attitude but mixed results physically.  Path report from surgery showed significant shrinkage of main tumor, but still some residual cancer in main tumor and in four lymph nodes.  It is that last fact that is most problematic.

    She has recovered well from the surgery in most respects.  The main caveat to that is that she still has signficant fluid build up on the cancer side nine weeks post-surgery.  She has completed 20 out of 33 radiation treatments and is contnuing to get avastin every three weeks.

     Hope that you are well.

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