Dose dense chemo and then surgery, for triple negative?

Good morning!

I think it is true that chemo before surgery is becoming more and more the norm.  It is also what I had.  I apprecaited having chemo first for a few reasons. One - you are getting whole body treatment as soon as possible, which means rogue cells are getting treated sooner...  Two - you have TIME to work out your surgical plan.  Three - you get to know the response of the cancer to the chemo (I - happily - did have the PCR - phew!).  

I am a little bit of a special case since I was enrolled in a clinical trial called ISPY2.

I received 12 cycles of weekly taxol, with carboplatin added for every third cycle.  I also took an experimental drug during this time.  The experimental drug made my counts drop lower, and so I had three delayed weeks...  

After that phase, I had the typical dose dense AC - four cycles - once every two weeks.  No delays during that phase.

After that, I had scans and then surgery.  I had a sentinel node biopsy, which was negative for cancer cells and a bilateral mastectomy. Happily, the pathological report concluded that I had a complete pathological response. This means my risk of recurrence is very low.  What a relief!

I hope this is helpful. 

Good luck!!!!

i wish i would have done chemo 1st for the reason's bikerlee mentioned.  i will never know if i had a PCR. 

Hi I too had chemo first then surgery. After AC x4 and Taxol x12 my tumor had shrunk by half Felt good to know that the chemo was working. It also felt good to know that I killing any cells that may have travelled out of my glands while awaiting surgery .Good luck with your treatment.

Hi there, BanR.  I'm also grade 3 triple negative and am doing chemo first.  I'm doing weekly Taxol x 12 (started on September 16) followed by AC every other week x 4.  I think starting AC first is more common based on what I've seen on these boards, though there are those that start with Taxol.  So far no major problems with the Taxol for me after two treatments.  Really hoping it stays that way!  Good luck with your decision and treatment!  Keep us posted.

Knight zoo, try and relax, although I know that is sometimes hard to do. I just want to reassure you, I was the same as you with regards to feeling my mass. I had a different chemo than you, however my tumour grew to 3.2 and was quite hard. It was also very sore and it was a constant reminder that it was there--or so I thought! My MO kept assuring me that it was getting smaller, which I could also feel, but the twinges of pain were always there. When I completed chemo and just before surgery, I could still feel "something" and was almost certain that I would not achieve PCR (to the point of researching what my next options were). Well after 3 weeks of unbearable waiting, I was astounded to learn there was absolutely no evidence of tumour and I had indeed achieved PCR. I guess what I could feel was scar tissue. My MO tried to assure me that the discomfort I felt prior to surgery was normal and quite indicative that chemo was working.

I hope this assures you a little, wishing you the best!

I did FEC D chemo (pretty standard here in Canada) and I could feel a softening by my second FEC treatment. It didn't feel smaller to me, but softer. My MO said that I would feel a marked change when she switched me to the D (docetaxol=taxotere) part-she was right, after the first D treatment, it definitely felt smaller to me but even after chemo was done and I was waiting for surgery, I could still feel something.i did 3 tx of FEC every 3 weeks then 3 tx of D every 3 weeks. Apparently what I had is called "high dose" chemo as opposed to dose dense.

Yep! As long as your MO is happy with your progress, try not to stress! Mine was very p,eased that she could feel a change by day 21, but again to me it was not a size change ( it felt just as big) but it didn't seem to be as hard. For me, I was more worried about the pain/discomfort I felt in the tumour. This may sound dumb, but ill share-I had it in my mind that I was feeling pain because the tumour was getting a blood supply and was "alive", so if I still felt pain-to me it was still "alive". My MO explained that what I was feeling was probably due to the tumour being attached to muscles and it was pulling those muscles as it was shrinking.

I also used l glutamine, 3 x a day while going through treatment. My MO said it was fine. I still take it 2x day as I have neuropathy in feet and hands. My hands are much better, but I still have quite a bit in my feet. I've gotten use to it and am hoping more will diminish with time. I also took B 6 as this is also suppose to help.