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BosnianHusband
BosnianHusband Member Posts: 7
edited September 2015 in Triple-Negative Breast Cancer

Hello everyone.

Im from Bosnia. My wife has a Triple negative breast cancer.

It was diagnosed five months after she had our fist baby. She was breastfeeding our daughter, everything was pefrect.

Then, over the night, she felt some lump 2 cm wide in her left breast. We went to ultrasound, doctor said it was just a cist. 2 months later after next ultrasound, it was not fluid in the lump, but solid mass of 3 cm. Fine needle biopsy said it was medullary carcinoma. Then we went to do mammography, MRI of the breast and CORE biopsy at last. mammography and MRI showed circular rounded mass but were not conclusive it was a cancer, but CORE biopsy and pathology report said it was a Triple negative breast cancer, with grade 3 for all criteria, so it was gradus 9. Then the same day ultrasound of her liver showed something that could be treated as metastasis of her cancer, and MRI of liver confirmed it.

She was scheduled for surgery, but oncologist said it would be wise to do neo-adjuvent chemo, which we did. Now, after the 1st chemo the lump shrinked to 1,5 cm. After the 2nd chemo there was nothing on her liver, according to ultrasound. After the 4th chemo the lump was no longer there in her breast. So, now after 6 chemo sessions, MRI of her breast and liver shows nothing.

She is scheduled for surgery on monday, 2 of her nodes will be removed and one quarter of her left breast. We fear that this is unnecessary since we even question the pathology result in the first place. Maybe this all had something to do with breastfeeding and when the chemo started, the milk was no longer there and the lump disapeared. Also oncologist was never sure that there was metastasis on the liver.

We fear that she will be over-treated.. we dont know. Are there any more cases that tumor grows and disappears so fast?


Any advice, opinion or experience is welcome.


EDIT - one more important thing.. my wife has perfectly clean family history, no woman in her family ever had a breast cancer or any type of cancer, for as long as they all can remember.

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited August 2015

    Hi!

    After five months of chemo, the active cancer in my breast and compromised lymph node appeared to be wiped out by chemo according to an MRI and PET scan. However, MRIs and PET scans only detect cancer cells when there are enough of them to register on these scans. Moreover, they may miss DCIS, cancer cells which are not invasive. Hence, I had a lumpectomy in which the surgeon removed a golf-ball size amount of tissue that included the surgical marker that had been placed in my breast during the biopsy. I also had 20 lymph nodes removed. The pathology report on the tissue and lymph nodes seemed to confirm that I was free of active cancer. However, the MRI had missed a tiny pocket of Grade 3, DCIS, which could be found in the golf-ball sized tissue. I was happy to have that pocket surgically removed. Even with the surgery, it is not always clear from scans as to what is going on at the microscopic level. So, I had radiation. Was I overtreated? I don't know, but I do know that scans do not necessarily pick up DCIS or microscopic-level cancer activity. So, I wouldn't rely on an MRI result to say that every cancer cell is gone and that surgery is unnecessary.

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  • BosnianHusband
    BosnianHusband Member Posts: 7
    edited August 2015

    Probably the main question I was having is... are the cases where cancer completely disappears after chemo so often? And patients after chemo still do the surgery and remove the tissue even though it appears that there is nothing wrong. We understand that a single cell, which can cause the problems later, cannot be visible on PET or MRI scan, but how do you decide than what is the amount of removed issue when you can't see anything anyway? How far do you go? Lumpectomy, quadrantectomy of the tissue where the cancer was, or mastectomy?


    This decision can save your life, but also can make it worse if you beat yourself about removing healthy breast, or part of it... I'm afraid that she (my wife) will be tortured by this decision later, if she doesn't feel now that whatever it is - it is the right decision for her.

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited August 2015

    Hi!

    A small percentage of women do have a pathological complete response (PCR) to chemo. However, a PCR can only be confirmed AFTER surgery, when the pathologist examines the tissue and/or lymph nodes removed. Until then, the cancer team recommends the treatment that a patient's initial diagnosis warrants. I was diagnosed at stage IIIa, with a tumor bigger than 5 cm. and one node that tested positive for cancer. Based on that stage, my team recommended chemo, surgery, and radiation. However, because chemo seemed to remove all of my active cancer, my surgeon supported my decision to have a lumpectomy rather than a mastectomy. He used the tumor marker as his target because that was where the tumor was originally situated. He reasoned that if that was where the tumor was initially situated, it was the place where any remaining cancer could be found. And, that is where he found the tiny pocket of DCIS.

    I don't feel tortured about having a lumpectomy. My surgeon did an excellent job of minimizing the impact on my breast; it retains sensation; and I do not feel like I need reconstruction to make me "whole."

    Good luck!

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  • BosnianHusband
    BosnianHusband Member Posts: 7
    edited August 2015

    Hi Elaine,


    That's an excellent example and I also think that you should be satisfied with everything about your case and decision, including your doctor's performance.

    Since we are in Bosnia, technology here in some cases is little behind United States, though I am confident in our doctors. The thing is.. because the tumor marker was never planted at my wife's breast during the biopsy, now we don't have an exact target like you did. And so it is a little harder. Because of that I fear that they will remove more tissue than they would originally need, but they did say that they will use MRI that was made prior to chemo for the purpose of orientation.

    First of all I hope it all goes well, and that she will have no signs of cancer in lymph nodes or her breast.

    And second of all I hope that she will be satisfied with how the surgery is performed physically.


    Thank you very much and I wish you long and healthy life with as less worries as possible!



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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited August 2015

    Hi!

    Prior to lumpectomies, surgeons usually insert some wires that tell them where to operate. My wires were inserted after a mammogram revealed the location of my surgical marker. I presume that your wife's surgeon will use the MRI (and possibly a mammogram? ) to ensure that he/she has some idea of where to operate. Best wishes for your wife's operation, and I'm hoping that she indeed achieved a pathological complete response!

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  • Moderators
    Moderators Member Posts: 25,912
    edited August 2015

    Bosnianhusband,

    How did the surgery go? How is your wife feeling? Any updates?

    Please keep posting to let us know how you're both doing!

    --The Mods

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  • Sejn
    Sejn Member Posts: 1
    edited September 2015

    bosnian husband, I sent you private message few days ago

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