Question I have not seen anywhere else on this board.

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larkwoodgirl
larkwoodgirl Member Posts: 2
edited June 2014 in Triple-Negative Breast Cancer

I am new to this board, and this is my first post.  I was diagnosed with a non-invasive DCIS tumor (less than 5 mm) in 2001.  I had a lumpectomy and 8 weeks of radiation therapy.  Since this tumor was estrogen receptor positive, I also took Tamoxifen for several years.  Until recently, I was cancer free for fourteen years.  In March, I found a lump, went immediately in for a mammogram (which I have annually),  A follow-up sonogram and biopsy revealed a 2.6 cm tumor in the same breast.  This tumor is a TN.  Since I had radiation on my right breast before, I was told that radiation was not an option, especially not on the same side.  Therefore, chemo and surgery were my best courses of treatment.  I am about to have my fourth dose-dense round of AC next week.  

Since my annual out of pocket maximum for my insurance is $3500 (which I have already paid for the year which ends on August 31).  My current chemotherapy regimen has me finishing chemo after that date.  Then the surgery will follow.  The out of pocket maximum for next year has increased to $5000.  I am a single mom and I could barely afford the $3500 for this year.  There is no way I could afford another $5000 out of pocket.  The surgery alone would exceed that amount.  My fear is that I will not be able to afford to get the surgery done, and there is no way in hell that I am not going to have the surgery.

I was considering (after the last dose of AC, which is working because the tumor is significantly smaller) stopping the chemo, having the surgery and them starting the Taxol after surgery.  

Does anyone have any experience or advice to share with me on this.  Will having the surgery in mid chemo be ok, or will it be a huge negative.  I desperately need some help here. 

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited May 2014

    If I were asking questions about 3N, I would do so at The Triple Negative Foundation

    http://www.tnbcfoundation.org/

    Hope you get the information you need there.  It is ONLY for 3N BC, which as you know, has it's own unique characteristics.

    Good luck.

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  • Moderators
    Moderators Member Posts: 25,912
    edited May 2014

    Hello larkwoodgirl, and welcome to Breastcancer.org. As well as the personal experiences you'll read from members about your treatment questions, we wanted to point you to a couple of other resources:

    From the main Breastcancer.org site, the section on Paying for Your Care that includes information on dealing with insurance companies, lowering medicine costs and much more. Also, here in the discussion boards, the forum Employment, Insurance, and Other Financial Issues can be a big help.

    • The Mods

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited May 2014

    I have a TN friend with a similar sized mass. She had a port installed and did a SNB prior to starting neo-adjuvent ACT chemo, because she wanted accurate staging She was node negative with no LVI. After tx#2 she started developing healing issues and an infection, even though her WBC was maintained with Neulasta. She had tx#3, but then had to stop on the advice of her BS and MO. She waited about five weeks and then had a BMX (she is 35 and BRCA 1+). She had about 30% reduction in size, and there were no surprises on pathology. It has been a month since her surgery and she is about to go back and start Taxol next week.

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  • larkwoodgirl
    larkwoodgirl Member Posts: 2
    edited May 2014

    Thanks for your reply SpecialK.  So far, I have no lymph node involvement and I am so grateful for that.  I want to make the right decision, but I feel like I am alone and don't have enough information.  Your response is so encouraging.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited May 2014

    lark - glad you found the info helpful. The issue with your timing is whether or not you could get this done before your new deductible year kicks in. You have enough time for the surgery and Taxol, I think it will come down to how you heal in between, and how many weeks you will need between AC and surgery, and surgery and Taxol. Have you considered a grant or a fundraiser to help cover the out of pocket cost if you have to go beyond Aug 31?

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  • jthomps24
    jthomps24 Member Posts: 1
    edited May 2014

    I was diagnosed with TNBC in October 2013.  I read the study that helped determine the course of chemotherapy today.  Basically, standard treatment recommends doing the full course of chemotherapy before doing the surgery for a more effective treatment.  The treatment won't work as well if you stop the chemo mid course to have the surgery according to the article.  I wish I had a link for you at this moment, but I don't.  Trust me, I had the same thought and continued the course of treatment because the effectiveness was better when you do the chemotherapy straight through before the surgery. 

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  • yogamommy
    yogamommy Member Posts: 115
    edited May 2014

    Hello Larkwood,

    I'm sorry you have to deal with so much at once.

    I had developed an infection after my SNB and finishing the AC, then surgery, then Taxol was almost an option.  My team was ok with that decision because it would happen in between chemo "types."  I ended up taking antibiotics for five months instead, in order to push through the chemo, but I was prepared to have the surgery before taxol if it came to that.

    What does your team say?

    Hugs.

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