Just found this interesting research

JudyO
JudyO Member Posts: 225

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  • Annette_U
    Annette_U Member Posts: 111
    edited April 2015

    I have read this before and it does not match my situation. I had Ki-67 of 63 at biopsy and a grade 1 at surgery. Perhaps because I had neo-adjuvant chemo, the results were not in line with this study. It would be nice to see more studies on disease free survival for those who have had chemo before lumpectomy and mastectomy. I guess since this protocol is fairly new we will have to wait years to see if neo-adjuv equates to higher survival rates.

  • JudyO
    JudyO Member Posts: 225
    edited April 2015

    I think Annette this study is right on. It states that the people were under treated systemically. They had almost not chemo and more than half did not receive tamoxifen. The chemo you had improved your survival, it took you from a hi KI-67 to a low. The people in this study didn't have that advantage. Judy

  • MmeJ
    MmeJ Member Posts: 167
    edited April 2015

    There are questions and current discussions afoot about the validity of the grading system for ILC (as a prognostic indicator).

    The studies that have been done so far indicate that there's no real survival difference between neo-adjuvant and adjuvant chemo for hormone-positive cancers.

    There is for the triple-negative cancers, though, since they are higher grade, therefore more responsive to chemo, therefore more likely to achieve pathological complete response which is a prognostic indicator.

    (That last sentence for some of the newer readers/newly diagnosed.)

  • vlnrph
    vlnrph Member Posts: 1,632
    edited April 2015

    Very interesting Judy - thanks for sharing it with us! I liked the fairly large sample size (almost 200 cases of ILC) and, done in Sweden, might have even included other descendants of my Scandinavian ancestors...

  • Annette_U
    Annette_U Member Posts: 111
    edited May 2015

    I did ask why I was receiving neo and the Oncologist and surgeon agreed this was to stop the cancer from seeding and I was a candidate because of my high Ki-67. I did have enlarged nodes at surgery (3) but they could not find any evidence of cancer in them. My husband (a scientist) has told me not to pay much attention to results of studies on small control groups. He says a control group should be at least 1000 people in order to qualify results.

    Thanks KayB for the input - I did not have a new Ki done on the mass after surgery or at least they never gave that info out. Perhaps they think it is useless at that point. I do wonder how much I had to start with seeing it was 4x3x1, in-situ (all quads) and stray foci all over left side.

    Mmej: Triple Negatives should get neo-adjuvant. I know a woman here who works at the cancer center and she was given a lumpectomy first, then chemo and rads. Her cancer was 3cm. However, it was ductal. I've yet to see a push for neo-adjuvant for most breast cancers. I wonder if it is because of "Old school Doc's……or nerves on the part of the patients". With ductal being more likely to be PCR then why aren't we saving more boobies?

    Another weird thing is why did I get FEC and most get AC or A/carboplatin? How do they know which drug to give? and what's the difference giving "Taxol and Taxotere"???

    Annette

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