Urgency of start time, 2nd opinion, and treatment questions

I had a very similar TNBC diagnosis to your mom. My tumor was larger, my lymph node was smaller but also high grade and aggressive.

My chemo was Taxotere and Carboplatin x 6, every 21 days. It worked very well on me. You might want to ask your team their opinion on that protocol. However, most people on this site with TNBC seem to get the AC/ T plan that your Mom's doctors are planning for her. (My MO felt AC was a harsher chemo and had more potential long term SEs than Taxotere/Caroboplatin.)

If she has a lymph node involved already, the haste to begin treatment is a little bit less. The horse is out of the barn, so to speak. I think it was 4 weeks from diagnostic mammogram to first chemo for me.

However, I think it's smart not to delay unduly. But -- if your Mom recurs, or if she might be a good candidate for an appropriate clinical trial, then being treated at MD Anderson could be an advantage in the long term.

Mostly, the initial chemos are "by the books," and not that likely to vary.

Wishing you and your mom the best!

Bcnav, your mom's diagnosis is virtually identical to mine except my lymph nodes were negative. I had the same chemotherapy as recommended for her, except that I had surgery before chemo. (The oncologist recommended chemo first like your mom's doctor, but I wasn't sure I wanted to go that route.) A second opinion can help you both feel more confident in the treatment plan. The study I've seen on the importance of beginning chemo ASAP was for people who have had surgery first. It recommended starting chemo within 30 days after surgery; however, the study intervals were 30 days, 30-60, 61-90, etc. You're talking about a brief delay. Due to a variety of circumstances and complications, my chemo didn't start until more than two months after surgery and, so far, I have no evidence of disease, if that offers encouragement.

I agree that it's worth asking about the carbo / taxane option in terms of efficacy and possible side effects. My friend was diagnosed about the same time I was. She works for a university-related cancer center and that's what they recommended. Yes, as Flynn said, try to get as much specific information about tumor characteristics as possible. My pathology report didn't, for example, address androgen or basal / non-basal status. Only later did I learn that those might impact prognosis, additional treatment options, or eligibility for clinical studies. As noted, MD Anderson would probably do those additional tests, but my Baylor facility pathologist didn't.

Whatever you decide, know that there are many wonderful people on this forum who generously share their experiences and what's helped them. I hope that your mom's treatment goes smoothly.

I think chemo is the norm for my Stage II, Grade 3 triple negative cancer, regardless of lymph node status. I was initially diagnosed as HER-2 positive and had chosen to go against medical advice, forego chemo and targeted therapy and proceed with surgery. As you've noted, chemo first is typical so that your mom's team can monitor how the tumor responds to the drugs. A complete response is related to a better prognosis and they'll only know if that happened if they can see the tumor shrink. My doctor recommended the AC+T instead of TC because of a study showing a survival advantage. I think there have been other studies with different findings. As you've mentioned, Adriamycin presents a greater cardiac risk and it's totally appropriate to ask the doctors to explain why they believe it's the best choice.

Regarding chemotherapy after surgery, I've not heard of that routinely being done unless there is a concern about the tumor not responding.

As to radiation, as I understand it, the chemo is a systemic attack on the cancer; that is, treating the entire body. Radiation is a local treatment isolated to the breast (and lymph nodes as appropriate). Think of it as a two-pronged approach planned to tackle the cancer in different ways.

I have no medical background what so am just sharing what I recall. It's unfortunate that your mother finds herself dealing with cancer, but I think she's lucky to have you in her corner learning as much as you can.

Lyn