Calling all TNs

Very pretty bed, too! Love the lace bed-hanging.

Hello all my TN ladies! I haven't logged on in a long while. I have tried to distance myself from Breast Cancer. I do think of all of you often. I hope everyone is doing well.

Love the picture, Heidi, and the bed looks sooooo inviting.  Would love to sleep under that pretty canopy.  I have two cats and both of them take turns sleeping on my chest every night!  And I wonder why I don't sleep well!

Michelle67 - OMG that is so funny.  I couldn't remember who Marty Feldman was so I googled it and busted out laughing!  That is great.

LOL!!!

TifJ: congratulations on your test results.  Sometimes a "triple negative" is a good thing!  What a relief for you not to have to worry about your precious daughter!

TifJ:  Congrats!!!  That is wonderful news!!

tnbcRuth:  I think what she meant was if a triple negative person gets the test for BRCA, if they test positive she was told that 95% of them would have the BRCA1 genetic disorder... not BRCA2.  I happen to be a rare bird in that I was triple negative and BRCA2+, which is fairly rare, but not impossible.  On the other hand, I believe probably 95% of BRCA2 positive people are estrogen positive for cancer.  Does that make sense?

As for boobie feeling.  Prior to my bilat mx, I was also feeling where the tumor was supposed to be, as well as everywhere else for any other lumps.  I had just about talked myself into having cancer in a lot of areas... but I didn't... and in my case, my tumor didn't grow while I waited for surgery.  I think the fetish with boobs happens to everyone who has had breast cancer, to one extent or another.  I never had much interest in my boobs prior to cancer... but now it's a regular thing.

Ruth- Angelisa is right. I just didn't explain it very well. It is rare indeed that Angelisa is BRCA2 and triple negative. My dr. didn't mention about the BRCA2 estrogen positive thing, but it makes sense to me. Angelisa- when your dr. gave you your results did he/she tell you it was rare?

TifJ:  When my genetic counselor went over the results, she really didn't have to tell me it was rare.  I had already studied up on it quite a bit, so I knew pretty much everything she was going to say once I knew I was positive.  It is true, most people who test positive for BRCA1 will be dx with triple negative, and most BRCA2 will be estrogen positive.  However, they do overlap some.  I know of other people on here and other forums who are part of this overlapping.  And I know of some people who have been first dx with triple negative BRCA2+ who went on to have a local recurrence and turned out estrogen positive then.  It's really a strange beast.  Sort of similar are the instances where two sisters, one positive/one negative, both get bc.  My half sister tested negative for BRCA, yet she had bc at 41 and just had a hysterectomy at 47.  I believe something is still in the blood in these cases but scientists haven't found the link yet.  There are so many different genetic things that can make a person susceptible to bc and other types of cancers that they simply don't know yet.

Moe: MilkThistle is great for clearing out the liver which can become toxic after chemo.  It's natural and it's inexpensive and you can read about it on BCO under the supplements page.  Congratulations that it's working.

Tif:  Yay!!!!

Moe0279: It hapened to me once on AC with Neupogen shots that my liver levels were high and it was because of the tylenol I was taking for the Neupogen pains. Tylenol is really hard on the liver. My doctor told me not to take to much. I listened to him and on my following chemo, my liver was fine.

Isabelle XX

Thanks Angelisa! I know that the "variant of unknown significance" may not be 100% negative. I was told that the specific defect has been found in 43 other people, but there has never been enough of a family history or other indications that required further testing for these people. My dr. did say that these defects are continually studied and say in 3 years (or whatever) they find this defect to be an actual cause of BC, then they would notify every dr. that has ever submitted this defect and then the dr. is responsible for locating that patient. He has not seen this happen in his career yet. I do not have enough family left to warrant further testing. The only blood relative I have is a brother. I am going to think positively, for once. and treat this as negative like my dr. told me to.

Ruth- i hope your ins. company gets off their a$$ and gets your test done- I will be praying for negative for you!

Moe- yay on the shrinkage!!!

Prognostic Significance of Triple Negative Breast Cancer at Tumor Size 1 cm and Smaller

Eur J Surg Oncol. 2011 Jan 1;37(1):18-24, HW Lai, SJ Kuo, LS Chen, CW Chi, ST Chen, TW Chang, DR Chen

Based on previous reports and this retrospective study from Taiwan, triple-negative tumor status is very likely an independent risk factor for small (<1 cm) node-negative invasive breast cancer.

TAKE-HOME MESSAGEBased on previous reports and this retrospective study from Taiwan, triple-negative tumor status is very likely an independent risk factor for small (<1 cm) node-negative invasive breast cancer.Abstract

Aims: The purpose of this study was to clarify the prognostic significance of triple-negative breast cancer (TNBC) with a tumor size ≤ 1 cm.

Materials and Methods: Patients with primary operable breast cancer with a tumor size ≤ 1 cm were enrolled at Changhua Christian Hospital and National Cheng-Kung University Hospital. Tumors negative for ER, PR, and HER-2 were classified as TNBCs and compared with tumors with any receptor positivity (non-TNBC) for disease-free survival (DFS) and cancer-specific survival (CSS).

Results: From 1995 to 2006, a total of 377 patients with tumor size ≤ 1 cm were enrolled. Compared with non-TNBC patients, TNBC patients with a tumor size ≤ 1 cm as a whole or in a lymph node-positive subgroup were not associated with a poorer 5-year DFS and CSS. In lymph node-negative patients (pT1a-bN0M0), TNBC was associated with a poorer 5-year CSS but not DFS. Compared with the hormone receptor-positive, HER-2-negative subgroup, TNBC was associated with poorer DFS and CSS. In the multivariate Cox regression hazard analysis, lymph node invasion was the most important cause of disease recurrence and cancer-specific death.

Conclusion: TNBC is very likely an independent risk factor in small (≤1 cm) node-negative invasive breast cancer. With tumors 1 cm and smaller, lymph node invasion was the single most important prognostic factor.

Don't you just love these f*cking studies? Who's on first... I don't know... he's on second, no He's on third. Blah blah blah...

Why don't they just say "nodes matter.... sometimes.... well, maybe once and awhile...sh*t, it's a crap shoot, we just like doing studies"

Not specific to TNBC,

Chemotherapy Sequence Affects Early Breast Cancer Outcomes

Elsevier Global Medical News. 2011 Jan 7, B Jancin

SAN ANTONIO (EGMN) — The sequence in which paclitaxel and anthracyclines are given for treatment of early breast cancer makes a big difference in long-term outcomes. That's the conclusion reached in what is believed to be the largest-ever retrospective study of the clinical impact of the sequencing of taxanes and anthracyclines. The study involved 3,010 early breast cancer patients who were treated during 1994-2009 and entered into the prospective online database at the University of Texas M.D. Anderson Cancer Center, Houston. The clear winner was paclitaxel, followed by anthracycline-based therapy with 5-fluorouracil, doxorubicin (Adriamycin), and cyclophosphamide or 5-fluorouracil, epirubicin, and cyclophosphamide, Dr. Ricardo H. Alvarez reported at the San Antonio Breast Cancer Symposium. Starting with paclitaxel rather than an anthracycline-first regimen led to better long-term results in the settings of adjuvant chemotherapy and primary systemic (or neoadjuvant) therapy. The adjuvant chemotherapy analysis included 1,596 women, three-quarters of whom received paclitaxel followed by anthracyclines. The 5-year relapse-free survival rate with this regimen was 88.8%, compared with 79.5% when anthracyclines were followed by paclitaxel. The 10-year relapse-free survival rates were 81.8% and 73.5%, respectively. Five-year overall survival was 93.1% with paclitaxel followed by anthracyclines, compared with 83.2% for the reverse. The 10-year overall survival rates were 83.9% and 65.6%, respectively. In a multivariate analysis that was stratified for potential confounders, including age, clinical stage, hormone receptor status, tumor grade, and era of diagnosis, the anthracyclines-first sequence was associated with a 67% increased risk of relapse (P less than .0001) and a 2.5-fold greater risk of mortality (P = .001), according to Dr. Alvarez, a medical oncologist at M.D. Anderson. Among 1,414 patients who underwent neoadjuvant therapy, the 5-year relapse-free survival rate was 79.0% with the paclitaxel-first regimen vs. 61.2% with the anthracyclines-first regimen. Ten-year relapse-free survival occurred in 61.7% and 50.5%, respectively, of these patients. Overall survival was 84.2% and 66.2% at 5 and 10 years, respectively, in patients who received paclitaxel followed by anthracyclines, compared with 71.3% and 53.4% in those who got anthracyclines first. In a multivariate analysis, the anthracyclines-followed-by-paclitaxel sequence of neoadjuvant chemotherapy was associated with an adjusted 49% higher risk of relapse (P = .01) and a nonsignificant 28% increase in risk of all-cause mortality (P = .17), compared with the paclitaxel-first strategy. The mechanism that accounts for the increased efficacy of taxane-first regimens for treatment of breast cancer is unclear, according to Dr. Alvarez.