Pathological complete response

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worriednlost
worriednlost Member Posts: 54
edited June 2014 in Triple-Negative Breast Cancer

Hi everyone

 My mom today received her post OP pathology report  and I have few questions.  She had 6 cycles of TAC chemo. After chemo, mastectomy with eleven lymph nodes removed.  Pathology report said pathological complete response and that there was no cancer found in the breast and one of the affected nodes had no viable cancer cells in it. Potential tumor bed was identified. She had a marker installed after 3rd round of chemo. The initial size of tumor was 4cm x 4cm (initial pathology) or close to 9cm when it was measured by surgeon. Shes will soon start rads about 25 sessions.  What does "pathological complete response" mean ? From what the oncologist said its the best news one can get. Are there any stats on "pathological complete response" ? Does this improve my mom's prognosis since she is inflammatory and triple negative ? Anyone with similar experience ? I don't know how to word this but should I be more optimistic or a bit less worried at this point ? 

Thanks 

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  • Leah_S
    Leah_S Member Posts: 8,458
    edited December 2011

    Worriednlost, it is excellent news! It means the chemo destroyed the cancer, which is exactly what you wanted.

    All the best to you and your mother.

    Leah

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  • LuvRVing
    LuvRVing Member Posts: 4,516
    edited December 2011

    It is indeed awesome news, worthy of a celebration!

     Hugs,

    Michelle

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  • bak94
    bak94 Member Posts: 1,846
    edited December 2011

    Hi worried,

    I am triple neg stage 3c but not inflammatory. I also had a pathological complete response. My doc said that 22-35 % have a complete response and of those 90% do not recur. I have seen in studies that it means an excellent prognosis and one said 94% overall survival for 5 years. I wish I had more info and will try to paste the link of the study I found a bit later. But basically it is about the best news one can get after doing chemo!

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  • Moderators
    Moderators Member Posts: 25,912
    edited December 2011

    worriednlost, we're all cheering along with you about such positive news!

    Judith and the Mods

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  • Momine
    Momine Member Posts: 7,859
    edited December 2011

    It means the chemo was completely effective. It is excellent news, because it means that the likelihood of any live cancer cells still roaming around is extremely low.

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  • worriednlost
    worriednlost Member Posts: 54
    edited December 2011

    Smile then its a perfect gift for the holidays Smile

    I still wish there was a cure for this terrible disease. Don't know what it is but I still can't sleep and it is 3:19 AM. Still trying to wrap my head around it, too much going on in my head.

     Thanks everyone for the support. 

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  • yellowdoglady
    yellowdoglady Member Posts: 349
    edited January 2012

    That DOES improve your Mom's prognosis and future.  It is what everyone wants to see and not all do.  Happy New Year!   

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  • worriednlost
    worriednlost Member Posts: 54
    edited January 2012

    Not sure if I am happy anymore. My my had a cough for a while that seems to be getting worse. She has shortness of breath. The cough seems to be worse if she is moving. When she is moving sometime she will get a runny nose.  I don't think she has a cold or a flu. If she goes up a flight of stairs she will (not continues, start and stops) cough for good  5-10 mins. She was coughing a bit before the diagnosis and before surgery. Doctors dismissed it as allergy. Should i be worried ? Could it be bronchitis ? She had her pet scans and chest x-rays. She will be getting another CT-Scan for rads next week. The good new does not seem to last long.

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited January 2012

    Worriednlost...When all of mom's scans came back clean and they told her she might have allergies, did she follow up with her PCP or an allergist?  You mentioned that these symptoms PRECEDED her diagnosis and are getting worse.  I'm not a doctor but, sometimes when people have coughing that occurs during and following activity...that's called "exercise induced asthma." 

    http://www.emedicinehealth.com/exercise-induced_asthma/article_em.htm

     So, it is quite possible that your mom DOES has an allergy.  Please make an appointment with her PCP and/or allergist as soon as possible so BOTH of you can start feeling better soon!

    I know how worried you are...you are a very dear daughter to be so concerned about her mother.  I will keep both of you in my thoughts and prayers. 

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  • worriednlost
    worriednlost Member Posts: 54
    edited January 2012

    When she was in the hospital and was on oxygen she was not coughing. As soon as they removed the oxygen she started coughing again.  Also i noticed that shes coughing at different locations. So I am not sure that it is an allergy. Wouldn't she feel better outside ?  Maybe the surgery made her condition worse. She did not see an allergist and it was not really followed up even though i did bring this up with the doctor multiple times. Since she had good response to chemo, could it be that something starter growing again ? Her hair is really started to grow and its been few month since her last chemo.

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  • Reality
    Reality Member Posts: 782
    edited January 2012

    "Complete response" is good news. I am triple negative - AC and Taxol reduced my tumor by 50% so I had a lumpectomy that removed half my breast. My path report found active cancer cells in my tumor, in spite of clear margins - so noone knows if there are also active cancer cells in my body - thus, my report of "incomplete response". I truly wish I had opted for a mx instead., but I allowed myself to be convinced otherwise....

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  • Reality
    Reality Member Posts: 782
    edited January 2012

      sorry - got caught up in sharing my path report and did not say congrats and best wishes to you and your Mom! 

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  • worriednlost
    worriednlost Member Posts: 54
    edited January 2012

    I am just hoping that it is an actual complete response and it did not move on to other places

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  • Claire_in_Seattle
    Claire_in_Seattle Member Posts: 4,570
    edited January 2012

    Hi worried,

    Chemo suppresses lung function, and anesthesia can also screw up breathing.  I am mentioning this because these issues could be related to your mother's treatment.  However, I agree that you need to get to the bottom of things.

    The complete pathological response is the greatest news.  This means that the chemo kicked her cancer to the curb.  That is so wonderful.

    I exercised all through active treatment, and I have to say there were times when I had respiratory distress.  I never would have noticed it if I hadn't been cycling, but I would have to work through not being able to breathe.  Then it would be fine.

    So do have your mother checked out, but wanted to share my experience.  Good luck with everything, but seems like all is onward and upward from here. - Claire

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  • Karen3
    Karen3 Member Posts: 307
    edited January 2012

    Great news about the complete pathalogical response! I agree with bak94 about the stats - I have done quite a bit of reading on this and those stats are consistent with what I have read. I had neoadjuvant chemo when I was first diagnosed in Sep 2009 but after four rounds of different chemo's my chemotherapy treatment was withdrawn due to nil response. This has plagued me since and of course I have just dealt with another cancer in my other breast followed by a recent bilateral mastectomy. By the way, after my chemotherapy treatment I had awful breathing difficulties / coughing. I was sure that the cancer had spread but of course things setttled down after a while and scans showed I was fine. I now have yet another lingering cough after a bad cold....it's so easy to jump to the worst case scenario in our situation. I agree with Claire that you do need to get to the bottom of things but most likely all is well.

    Karen.

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  • chilimac
    chilimac Member Posts: 20
    edited January 2012

    I agree that it's great news about your mom getting a complete pathological response.  My sister got one as well, but I wanted to reply because my sister had a cough prior to chemo and it got worse after her first round of AC.  She did taxotere first and the cough was only minor, but then she had AC and developed a much more pronounced cough.   Just like you, I was so scared and worried all the time.  I would get it checked out, but I'm wondering if your mom's cough became more pronounced because of the chemo?  Also, with allergies and asthma it doesn't really follow a pattern  all the time.  I have asthma and one of my only symptoms when it is uncontrolled is that I have a very annoying cough that keeps me up at night.  I know it's important following treatment to get everything checked out, but I just wanted to give you some info on allergies/asthma.  

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  • worriednlost
    worriednlost Member Posts: 54
    edited January 2012

    @ chilimac .. she was coughing a bit before chemo and it kinda remained the same then she had surgery and maybe a month after surgery it i think became worse. She never had allergies or Asama, never been a smoker. Overall she was in good health prior to diagnosis. Maybe a little bit out of shape and a bit overweight but now by much. Right before the diag. she lost lots of weight but she seems stable now. She had a flu shot before the flu season. Don't know what to think. Going to see the surgeon for the first time since the operation. Then CT scan and medical oncologist on Thursday. Going to demand that they get to the root of the problem.

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  • worriednlost
    worriednlost Member Posts: 54
    edited January 2012

    Hi everyone here is a quick recap and an update. This is a cross post.

    Shortness of breath, aggravated by exertion. 

    My mom went through chemo and surgery and was told she is NED. The original diagnosis was triple negative inflammatory breast cancer. It was only in the breast and it touched one node. PET scan was done. Two months has past since TAC chemo and one month since surgery (MX). There was no cancer found in the breast or the node and the pathology report came with good news. She had a cough before diagnosis that remained at the same level. I mentioned that multiple times to the oncologist and his reply was that it is normal sometimes and  it could also be a side effect of chemo. In the last month or so her coughing  and short of breath became worse and is felt when she is moving or being active. If she is sitting down she is ok. She has somewhat dry cough. There were multiple tests done on the heart, the heart seems fine. Last week's chest x-ray shows up normal. Last week's ct-scan came in with some defuse  something (inflammation ?).  The was no solid mass. Fogging in the lungs ? She was given a diuretic and that did not work, so now she was given a steroid to remove the defuse inflammation, started taking them today.  Today we saw her rads oncologist and he seemed alarmed but he didn't say much. He postponed her rads marking and treatment by 3 weeks.  We have met him for second time and I am not sure if it just his style or there is something to really to worry about or he is speculating. 

    Anyone had a similar experience or has any words of encouragement. She is being seen by a  pulmonologist and he is overseeing the diagnosis.  Going to meet the medical oncologist on Thursday and not sure what to expect. Really nervous Frown and hoping its not mets to the lungs.

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  • yellowdoglady
    yellowdoglady Member Posts: 349
    edited January 2012

    I had allergies and asthma before treatment, and I have them now but a bit worse.  There is no sign of mets.  Just a tougher time with what went on before.  I've been told that the radiation can be hard on the lung below the treatment site.  I suspected that not being able to clean the house properly during treatment did not help as I am hellishly allergic to house dust.  I am well now, but still have more asthma symptoms than before.  If I need a little more medication to keep from wheezing, I'm okay with that.  I didn't like the alternative at all. 

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited January 2012

    http://en.wikipedia.org/wiki/Interstitial_lung_disease

    The above link explains:

    Interstitial lung disease (ILD), also known as diffuse parenchymal lung disease (DPLD),[1] refers to a group of lung diseases affecting the interstitium (the tissue and space around the air sacs of the lungs). [2] It concerns alveolar epithelium, pulmonary capillary endothelium, basement membrane, perivascular and perilymphatic tissues.

    Hope it helps you and your mom understand better why she's coughing.  Sounds like she has lung inflammation from her chemotherapy.  It's treatable! 

    Good luck!

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited January 2012

    May I also make a suggestion....When your mom goes for her visits to the doctors, why not bring a tape recorder.  Also, ask the doctors to write down their diagnosis and also ask for copies of the reports.  All of these things will help you and your mom better understand her diagnosis and treatment.

    Good luck!

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  • worriednlost
    worriednlost Member Posts: 54
    edited January 2012

    Went to see the medical oncologist today. He sort of reassured us that it doesn't look like it's cancer related. I asked for more tests and he said she has enough tests for now. I did read up on ILD just was not sure if its possible to have lung mets without a mass. I asked about allergies the oncologist kind of brushed that off. He told her to stick to treatment plan of the lung specialist and keep taking the steroid pills. As far as reports I do always get em and today i even went through her file at the hospital didn't find anything new in there. Been a rough few days the radiation oncologist really alarmed me, was not able to sleep for few nights. Hope the lung situation improves by tomorrow because I have to check in with pulmonologist and give him an update.

     thanks for support 

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited January 2012

    I wish you and your mom well!  You sound like a terrific daughter.  My mother has pulmonary issues, as well and it is very frustrating.  She keeps going to the pulmonologist and he keeps telling her that her lungs are functioning well (  despite a recent bout with a favorable lung cancer) and yet, my 86 year old mom continues to have shortness of breath.  Glad to hear you keep copies of her reports.  That's very important!  Good luck!!!!

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  • worriednlost
    worriednlost Member Posts: 54
    edited January 2012
     My mom tells me I am a wonderful son  Smile .  But honestly if i could i would switch places with her.  I try to stay very positive and strong when I am around her, but on the inside it's a totaly different story.  It hard to deal with things. I constantly worry about her. My life changed as well. Seems like everything is on hold. Just living from one day to another. Dealing with cancer from the sidelines is hard I cant imagine how it is for my mom. I really hope she can get better and a more normal life can begin.
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  • worriednlost
    worriednlost Member Posts: 54
    edited May 2012

    Hello everyone. Not sure if someone is till following this topic, but i'll give an update. My moms lungs cleared up and so did the cough, but her brain now has a problem :(. She was diagnosed with mets to the brain. Will go through whole brain rads for 5 days and hoep that it shrinks the buggers.  :(

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  • BikerLee
    BikerLee Member Posts: 355
    edited May 2012

    oh my gosh - I am so sorry to hear of this diagnosis...  What terrible news.

    My heart goes out to both you and your mom.

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  • worriednlost
    worriednlost Member Posts: 54
    edited May 2012

    It is shocking to say the least we were given a clean bill of health the day before. The whole body ct-scan was also fine. The head scan was only done in october of last year. The day after the oncologist said we are cancer free the unthinkable happened. :( A complete 180.

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