Calling all TNs

That sounds like such a small variation from 32 to 37.  I think if you hadn't fasted, then that's probably what the difference is, especially if you fasted for the exact same test last year.  My Onc looks for a pattern of continuance, rather than a one time fluctuation. Also, were your labs done last year before mx, but after chemo?  Because after chemo, it can time for things to appear normal.  

Hi Cocker!

When I responded to Melissa that it didn't seem like much of a difference, that was because her ranges were still below the considered 'high range' according to her post, and I thought liver and kidney values can fluctuate somewhat without alarm.  With tumor markers, I've also heard that they look for trends, but I don't know how much of a variation they allow for a tumor marker either.  I think your Oncologist will tell you when it's time to worry a little. Did he offer any information besides the number?

To all triple negatives - I just read on another post that few triple negatives ever have a lumpectomy - this is news to me - now I am concerned because I had a lumpectomy and it was never suggested to me that I have a mastectomy. 

I'd like to know how many women have had a lumpectomy? Feedback would be appreciated!!

I saw that other post, and I believe many were posting in reply to that, asking for additional information or a retraction, as they felt it was not the case.  On these boards, I think it's split pretty evenly, lx and mastectomy.  I seem to run across many profiles and it seems to be about the same.

I had a BMX.  My BS basically said that most women have an idea what they want before they even see him, and I told him I wanted a BMX, and I talked to him about why I wanted to do that.  At the meeting we did not know I was Triple Negative yet.

It's stressful to wonder if we got the right treatment, the strongest treatment, etc.  Just remember, your medical teams knows all about you, your pathology report and I'm sure they gave you the recommended protocol for your situation. 

Hope this helps!  

That's great news!  I have surgery on Wednesday.  I have saline implants, but they rotated around, so he is putting in new ones for me and cleaning up scar tissue.  

Hope:  It is a breast cancer tumor marker.  Some Oncologists do them, some don't, because of the false positives and having to put the patient through the anguish of waiting.  Some feel that if something is wrong, it will hit other labs as well, without having to look at a specific tumor marker.  Some women have recurrences, with normal markers, and some have elevated markers with no recurrence.  

Adagio, I posted on that thread also. There are tons of us who have had lumpectomies. I found Alny's comments unacceptable. For those who haven't seen it, she said TNs never had lumpectomies. Luah and I both called her on this. Adagio, your reaction to her comments are what I find so worrying, because YOU are now concerned you didn't get the right treatment. You did get appropriate treatment.

Keke - welcome! I am so sorry you have to join the club - but we'll all be here for you for advice, hand holding or just listening to you vent in a safe place.

It seems the current protocol is as explained to you above. 4 rounds of A/C combo then 4 rounds of taxol or taxotere. I am not sure how they are space out, but it may be every 21 days. 24 hours after treatment, you may have a Neulasta shot, which helps keep your white blood cell count up.

Some doctors do surgery before chemo and some do it after, so they can scan you to see if the tumor had a good response.



I think there is a page on this site, that yells you about all the chemo drugs. You may find that helpful.



If you have any questions just ask, and once you start chemo you may want to join another thread that will match you up with women starting chemo on the same month.



Wishing you all the best.



Annie - so glad you were able to rest and get some things done around the house. Sure hope dear, sweet Chloe doesn't find a way to sink her teeth into the new table.

DorMac,

Thanks for the letter it really created some great visuals in my mind. LMAO.

Sheryl

Oh Almy, don't leave our boards.  It is just a misunderstanding, and you posted what you have conviction about.  it opened up a great discussion, and the more we talk about things, the more we can gain insight and information.  

logoff aka almy: I'm sorry you feel a need to sign off, but with respect, I will continue to challenge your statement that "in common medical practice lumpectomies are generally not recommended for TNBC even in early stages." And in case you are checking in, thank-you for sharing those links. Hard facts are always appreciated! (I am, admittedly, a research junkie.)

I do wonder, in one of those studies you cited, whether those were medically required re-excisions because if so, that suggests pre-existing increased risk i.e. not good candidates for Lx to start with for other reasons perhaps... Also, the study fails to consider whole treatment: Lx is virtually always performed with radiation, which seems to have its own protective qualities for TN (see below). So while some residual disease may have been found in that sample, it by no means proves any altered/worsened  outcome.   

When you consider studies like these:  http://link.springer.com/article/10.1245/s10434-011-1920-z and http://jco.ascopubs.org/content/early/2011/06/09/JCO.2010.33.4714 it is obvious that there is plenty of recent evidence to support an alternate view to yours. 

Finally, I would like to clarify, in case there was some misunderstanding, what was most alarming about your post was your assertion that BSs do not recommend Lx for TN (anymore). That is simply not the case, which hundreds of women on these boards clearly demonstrate... not to mention surgical practice guidelines. And yes, I think it does breed anxiety when women in the boards are second-guessing their BS' recommendations, based on an opinion, not fact.

The point gilly and I and others were making is that BSs make recommendations based on the factors and risks presented by individual patients....  many/most do not consider TN in and of itself to be salient, and I have indicated several links to show that. You're entitled to think they're wrong for that (based on a few pieces of research), but not to say that those (thousands of?) doctors don't exist.       

Keke,



For chemo, I was given 4 rounds of adriamyacin cytoxin, delivered every two weeks, followed by 12 rounds of taxol, delivered every week. I was a later stage (2) and had one lymph node involved. For my individual situation, I was told chemo was required and had to start "right away." I had a hard time with AC, an easier time with taxol.



I am still glad I did chemo as even with these "big guns" my tumor did not entirely go away...it did shrink by 78 percent, and the proliferation (something called ki67) dropped from 70 percent to 17. That's supposed to be a good sign. I chose aggressive treatment (eg radiation even though I had bilateral mastectomy), but that is just me.

Adagio,



I initially posted the below to the wrong thread. The study I mention is only one study. As has been mentioned, oncologists and breast surgeons give their patients a wide variety of recommendations as to treatment...both overall and specific to the individual women/their situations. I lean toward more aggressive treatment because I have (had?) a very nasty tumor. And my intuition told me to.



I had a BMX, and I am getting radiation. (I chose prophylactic mastectomy on the non-cancer side.) According to the quote below, for early stage, triple negative women under age 50, having the unaffected breast removed improves survival.



"Only limited data are available on the survival impact of mastectomy contralateral to a unilateral breast cancer.  Analysis of women included in the Surveillance, Epidemiology, and End Results (SEER) database treated with mastectomy for a unilateral breast cancer during 1998-2002 showed that contralateral mastectomy performed at the time of treatment of a unilateral cancer was associated with a reduction in breast cancer-specific mortality only in the population of young women (18-49 years of age) with stage I/II, ER-negative breast cancer (hazard ratio 0.64; 95% CI, 0.44-0.94; P = .025)."  Source:  National Comprehensive Cancer Network, NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines), Breast Cancer, Version 2.2012, NCCN.org, page MS-12.



I know that this doesn't answer about mastectomy vs. lumpectomy + radiation. My doctors told me that mastectomy has a lower risk of LOCAL recurrence, compared with lumpectomy, although it does not improve survival. For me, that was enough.

Just want to chime in. My BS gave me the option if lx or mx. She said it was totally up to me and that she could def do a lx and was confident she would get clear margins. But I chose otherwise. Just my choice for maybe a little more piece of mind :-)