Large tumors and pCR

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iChan25
iChan25 Member Posts: 17
edited June 2019 in Stage III Breast Cancer

My tumor was originally around 4.6 cm and after 4 rounds of AC it was around 2.8 cm by ultrasound. I had one round of TCHP after that and it doesn’t seem to have caused shrinking the way AC did, where I could feel it smaller after every round. Still have 3-5 rounds of TCHP to go. My oncologist is pleased with the shrinkage but we can still feel quite a large palpable mass.

Since my tumor is hormone negative Her2 positive, it’s the most likely type to get a pCR with neoadjuvant chemo. But my oncologist said that pCR is more likely in smaller tumors than with larger T3 tumors.

I’m quite concerned because the prognosis for HR- tumors isn’t great for those who don’t get a pCR since we don’t have the option of hormone suppression.

Anyone with a large tumor get pCR? Could you still feel a mas or did the tumor melt away and was no longer palpable?

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  • Newfromny
    Newfromny Member Posts: 139
    edited June 2019

    I had a large tumor 5cm had 6 rounds of TCHP and got pCR. Had an ultrasound after 3 rounds and the tumor had shrunk significantly but was still there. After 6 and surgery it was gone including 1 or 2 nodes that had tested positive.

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  • iChan25
    iChan25 Member Posts: 17
    edited June 2019

    That’s awesome Newfromny! Could you still feel something after your 6 rounds or did it completely disappear?

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  • Newfromny
    Newfromny Member Posts: 139
    edited June 2019

    After 6 rounds I didn’t feel it, but I still did after 3.

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  • kber
    kber Member Posts: 394
    edited June 2019

    I had 5+ cm according to my mammogram and ultrasound, and 8+ cm according to my MRI. 4 rounds of AC and then 12 of Taxol and Carboplatin. I couldn't feel anything after AC and achieved pCR in the end.

    My doc agrees that smaller tumors are more likely to result in pCR. However, another factor is how quickly it grew. Fast growing tumors are more responsive to chemotherapy. So a tumor that grew large quickly may also melt quickly.

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  • iChan25
    iChan25 Member Posts: 17
    edited June 2019

    Kber- it’s so great to hear that you had such a good response to AC. My tumor was very fast growing too, came out of nowhere, grade 3, high mitotic rate and Ki67 60! So we fully expected it to respond very well to chemo. Oncologist says it might just be a lot of inflammation and not necessarily everything we are feeling is the tumor. But he did say the typical response is for the tumor to ‘disappear’. Guess time will tell..

    It must have been such a relief to learn you had pCR. Hopefully I can hear those magic words too in a few months :)

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  • kber
    kber Member Posts: 394
    edited June 2019

    best of luck iChan!

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  • Kkmay
    Kkmay Member Posts: 156
    edited June 2019

    kber did you feel something hard in your tumor prior to surgery? What changes did you notice in your tumor throughout chemo (other than shrinkage)?

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  • Lexica
    Lexica Member Posts: 259
    edited June 2019

    My tumor felt like it was gone post neo-adjuvant chemo, but I still had most of it left after surgery. I am HR+, so I know it is a different situation. A friend that went through neo-adjuvant chemo around the same time as me was Stage III (so, large tumor, but I don't know the size) HER2+ and received pCR. She said her surgeon told her her nodes were also clear but matted together.

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited June 2019

    Hi!

    I had a 5 cm. tumor (with a little satellite friend) that disappeared after AC X 4 and THP X 12. After surgery, the pathology report said that the surgeon only found a tiny pocket of DCIS (which wouldn't have been affected by chemo anyway). I was Grade 3, 95%ER, 95% PR; my oncologist says that my cancer's growth was definitely driven by the overexpression of the HER2 protein, rather than by hormones. That's why, she reasons, chemo worked well for me.

    I could definitely feel the lump disappearing. It was quite close to the skin, and MO would measure it (with a ruler!) during my pre-chemo appointments. It really seemed to lose a lot of mass during the Taxol + Herceptin + Perjeta treatments.

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  • Beesy_The_Other_One
    Beesy_The_Other_One Member Posts: 274
    edited June 2019

    IChan! You and I spoke a while back. I also had a large ER-/PR-/HER2+ tumor. At the biopsy, at its largest measurement it was 1.5 cm (US). Exactly two weeks later, MRI measured it as 7 cm at its largest measurement. It was horrifying--even if the MRI might be exaggerating size a little. I did six rounds of TCHP, and while I could feel it getting smaller and the MRI and US both showed it getting smaller six weeks before surgery (though within a day of one another, MRI was showing it twice the size as US did), I could always feel something there, even the day of surgery. So I went into surgery thinking there was some amount of tumor there (and I would have to beg for Kadcyla) but in fact, what I must have been feeling was the tumor bed. There were no live cells in the breast or nodes. For what it's worth, since you're also in Houston, my doctor at MD Anderson said that I would not have had to beg for Kadcyla--😊--they give it to all ladies in our situation who don't achieve a pCR--so don't lose hope yet!

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  • Kkmay
    Kkmay Member Posts: 156
    edited June 2019

    ladies, did you feel any pain and/or contractions in the tumor during chemo? If yes, when did it start or stop



    Do shrinking tumors cause pain during chemotherapy?

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