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adagio
adagio Member Posts: 982
edited June 2014 in Triple-Negative Breast Cancer

I am 65 years old and was just diagnosed in August, 2012. I had a lumpectomy on September 25, 2012. The pathology report has come back telling me that I am triple negative, stage 2 invasive ductal, grade 3. Two out of three lymph nodes have isolated tumor cells. Also, two of the margins are 0.5millimetres which I do believe is small. I see the breast surgeon next week to discuss all of this, and then I have the oncologist on October 30th.  Needless to say, I am pretty scared and don't really know what to expect. I got my report from my family doctor ahead of time, so I have been researching all of the results. 

Any ideas on what the possible outcomes of this kind of result could be? I am expecting chemo - but also wonder about more surgery?

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  • bak94
    bak94 Member Posts: 1,846
    edited October 2012

    The waiting part is so difficult, waiting for a treaatment plan. I am not sure about more surgery, they may want more clear margins. I just wanted to welcome you to the boards, and am sorry you have to join us here but you will find great support.

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  • Knitwitmn
    Knitwitmn Member Posts: 1
    edited October 2012

    I know exactly what you are going through.  I was diagnosed in Sept. with IDC triple negative and had a lumpectomy last Thursday.  Just got off the phone with my surgeon.  Pathology report indicated that margins are 1mm from edge in two places and they want 2mm margins, so will be returning for further surgery next Wed.  The sentinal lymph node was negative (the only good news I've heard so far) but of two lymph nodes within the breast one was positive and the other negative.  I have not seen the actual report from the lumpectomy but the initial biopsy indicated a Nottingham score of 6 and the surgeon claims that this is stage IIB.  Using the TNM scoring so far I am T2, N1 and, based on what I can figure from PET scan ordered by the oncologist, M0.  I agree with prior posts, waiting for information is the most difficult and frustrating part of this whole process.  In addition to the fact that I am tired of being poked, prodded, jabbed, sliced and diced...and the treatment portion has not even begun.  I too will be having IV Chemo  in addition to radiation but will not know the plan until I meet with the oncologist on 11/5.

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  • beachmd
    beachmd Member Posts: 19
    edited October 2012

    I know what you are gong through, just had surgery mon. No nodes but have to go back cause he wants better clear margin. It said it will be like scraping a cucumber.

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  • adagio
    adagio Member Posts: 982
    edited October 2012

    knitwitmn - one of my margins was a mere 0.5 mm and it is the posterior margin. The breast surgeon said she has gone right to the chest wall and can go no further - so nothing at all can be done!! A little scary to say the least!! I see an oncologist on October 30 to discuss prognosis and possible treatments. I am so scared of chemotherapy and am not convinced that the benefits of it outweigh the negatives. It is going to be a tough decision for me. Do you mind me asking your age? 

    beachmd - so many women have to go back for better margins. I was expecting that also.

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  • txjunebug
    txjunebug Member Posts: 212
    edited October 2012

    I'm so glad I found this thread!!  I was diagnosed Sept. 20th and  had lumpectomy Oct 8th.  Like most of you, they didn't get enough of a clear margin on me too.  Mine was .66mm on inferior edge.  Had re excision on Oct 22nd.  Surgeon said we have a 3 mm edge all around the other areas .  The second surgery was much easier than the first.  I think I had a harder time with the sential lymph node incision than the other one.   

    Discussed 1st path report with surgeon.  No node involvement, vascular invasion was not determined (not sure what that means) Nottingham score was 9, and it's triple negative.  Bone scan was negative, CT scan was unclear on an section of the liver and sonogram could not determine what it was so I had MRI on Thursday and am waiting for results.   Surgeon said she would classify me right now as a Stage 1 but with the TN status I would probably need chemo  BUT staging was dependent on what MRI shows.  Now I'm wondering if it's possible to not have negative node involvement but for it to appear in other parts of the body.  All the attention to the liver is concerning.  I do not feel sick.  I guess that's why I am having a difficult time with all of this.  I repeat I don't feel sick, hurt or have odd pains anywhere.  

    Nurse called about 2nd pathology report (report from re excision) which showed no signs of cancer at all.  DH and everyone is all happy about that result.  Me, I'm still nervous about the liver and reoccurence.  Nurse said " it looks like we got it all".  I was thinking the whole time "can you tell me it won't come back??"

     See the MO on Monday for the first time 10/29.  I feel like I'm doing this in backwards order after reading some of the post on this website.  I don't know that I would be seeing the same MO before surgery.  I wouldn't have anticipated the triple negative status.  I sought out someone in the north Tx area that specialized in the treatment of breast cancer.  Before surgery I would have picked someone closer to home.  I live in a small town and the town near us has a hospital with some MOs that come down once or twice a week but none of them specialize in breast cancer.

    Knitwitmn  - I understand that feeling of being tired of all the testing, scanning, poking, etc.  As DH, said they're now on a biological scavenger hunt.  Trying to see what else needs to knocked out.  He has been great thru the process but it's not him who is getting shot with nuclear meds, stuck in a tiny tube and stuck repeatedly with needles and IVs.  I told my friends I feel like a human science experiement!  The only people I feel that truly understand this are the ones that have been thru this.  The waiting is horrible.  The not knowing keeps me up at night and makes me feel like I'm now obsessed because it's all I think about.  Only the people on this board seem to understand that.

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  • Luah
    Luah Member Posts: 1,541
    edited October 2012

    Adagio: Your stats are not that different from mine, although I was 52 at diagnosis. I had two tumours and 1 mm posterior edge, which was right to the chest wall. Nothing more to do. While scary, this is of note for your radiation oncologist, who will take that into account when planning your radiation treatment. 

    Because of the number of isolated tumour cells in my sentinel nodes (enough to classify as micromets), I had additional surgery to remove all lymph nodes. No more cancer was found, which was a relief. At the time, this surgery was considered standard of care for what was becoming a bit of a grey zone; I believe thinking has since shifted, and more docs would look to rads to solve any small nodes risk rather than surgery. You may want to ask your MO about that. Chemo seems very scary, but once you're in treatment, it's all doable. 

    I am now more than 3 years out - and doing well. I will bet you'll be saying the same too!

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