Calling all TNs

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  • Farfalla6
    Farfalla6 Member Posts: 105
    edited August 2019

    mountain Mia, I also want to know and have been exhaustively researching on line and there’s not s ton if data for stage 1 tnbc. In a way that’s good: a lot of studies are based on tnbc being caught at later stages, and survivals stats are lumped together. I have found info that says , in stage 1, size of tumor under 1.5 cm, absence of lymphovascular invasion, and number of tils ( tumor infiltrating lymphocytes) —the higher the better—are associated with ongoing survival with lower risk of recurrent or metastatic disease. But no numbers, and my oncologist says things like “you’ll be fine” but when I press for statistics they are vague.

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited August 2019

    It seems to depend more on response to chemo than stage at diagnosis.

    Roughly 30% of TNBC patients get a pCR. I know that the recurrence rates are about 10% for people who get a pCR, and more like 40% for people who do not have pCR. Nearly all TNBC recurrences will be within the first 3 years, and after 5 years recurrences are vanishingly rare. (Of course, one can always develop a new primary.)


  • MountainMia
    MountainMia Member Posts: 1,307
    edited August 2019

    I had adjuvant, not neo-adjuvant chemo. My tumor was 1.5cm, removed with clean margins and no lymph node involvement by lumpectomy. Is that equivalent to pCR?

  • Farfalla6
    Farfalla6 Member Posts: 105
    edited August 2019

    mountain Mia, I am the same. We can't tell if we had pcr because my tumo was removed fully before chemo and radiat. So it's good to have a smaller tumor, but since pcr is a sign of a great response, we can't know if we would have had that with a larger tumor. So while it's good it was smaller it takes away a piece of information that could have been reassuring. I don’t think it’s equivalent to pcr. There is recent work on tils that suggest that a high percentage of them in tumor ( more than 50%) is associated with a pcr. I hang on to this since my TILs were 70-80% according to pathologist.

  • jrominger
    jrominger Member Posts: 349
    edited August 2019

    mountainmia. It sure sounds like cPR!!! Nat’s tumor was 2.5 cm. We did AC and finished Taxol #3 yesterday. Our MO said that currently there is no node involvement and if that is the case after BMX and the margins r clear she should be good to go with no radiation. If something in the margins we will do 6 weeks of radiation. Yours sounds VERY positive and we hope to be where you and santabarbarian are later this fall!!

  • VL22
    VL22 Member Posts: 851
    edited August 2019

    Unfortunately, if you have tumor removed prior to chemo, there is no way to know if you would have pCR.

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited August 2019

    Farfalla, that TIL number is wonderful and indicates you would likely have/had a great response.

  • jrominger
    jrominger Member Posts: 349
    edited August 2019

    santabarbarian I have a question for you. My wife, Nat and I are walking/hiking over 20 miles/week. Nat is a big work out person and this activity is so good for our spirits!! Her RBC’s are dropping of course because of chemo and we don’t want to go so low that we have to have a delay. What has your research shown about aerobic activity during chemo?? Our diet is nutrient dense, high protein and iron but we do have to be careful of too much fiber due to bizarre diverticulitis episode during AC 9 weeks ago. Thanks.

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited August 2019

    I kept going on my workouts during chemo. I was very low RBC as well. They got hard to do wind-wise. I had to rest a lot. So I would go, take lots of rests, and have it be double the time to do the normal hike. The integrative onc I saw wanted at minimum 20 mins of interval training (30 sec @ medium intensity, 30 sec @ high intensity done 3 times; then a 3 minute sit down rest, then this sequence repeated 3 total times).

    Between chemo 5 and six I did not get back to full routine but I did do 2x pilates and a 2-3 x medium intensity walk through to the end.

  • jrominger
    jrominger Member Posts: 349
    edited August 2019

    Santabarbarian you rock!! Great info!! Our workouts are so important to us. Thank you for your quick response. We r following in your footsteps!!! Shooting for that cPR in October!!

  • MountainMia
    MountainMia Member Posts: 1,307
    edited August 2019

    jrominger, the way I understand it is this: one of the few "benefits" of TNBC is that it typical responds well to chemo. When it doesn't, since there aren't many other weapons to use against it, things can go badly. If a patient has neo-adjuvant chemo it's easier to see if there is a good response. Either the tumor shrinks and by all evidence disappears (pCR, or pathologic complete response,) or it doesn't.

    If surgery is done before chemo, as for me and Farfalla6 above, there isn't a way to tell if the chemo is successful or not. It isn't actually a pCR, because pCR refers specifically to the effect of chemo. I have no evidence of the effect of chemo. It might have been effective or not, and I won't know until I either have a recurrence or die without one.

    Here's a definition of pCR. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/pathologic-complete-response

  • jrominger
    jrominger Member Posts: 349
    edited August 2019

    MtnMia is excellent info and inspirational as Nat’s tumor has basically disappeared with the AC chemo!! So we are very hopeful the Taxol will continue to destroy the tumor!! Thank you for your input and God bless!

    Santabarbarian we r off for another hike!! She is charged up... maybe the steroids 😜

    Thank you both!!

  • ucfknights
    ucfknights Member Posts: 102
    edited August 2019

    My mom's surgery is the 19th and i am already stressed to the max.. i even have chest pains and I'm not the one going through it. We had MRI Monday and tomorrow is for the results. How accurate is the MRI after chemo prior to surgery? has anyone had something show up on the mri then nothing in pathology or nothing show up in mri but something in pathology? Thank u

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited August 2019

    I think the latter possibility (that it looks good on MRI but turns out that there are micromets in tissue) is something that can happen. My MRI appeared perfect but they did not want me to count on it.... Though MRI looked great, my surgeon said, "Pathology trumps MRI, so we need to do the surgery and see what pathology says."


  • moth
    moth Member Posts: 4,800
    edited August 2019

    re exercise during treatment - do as much as you can!

    Video about an ongoing research project in Australia on this https://www.youtube.com/watch?v=ffgAVrANmS4

  • jrominger
    jrominger Member Posts: 349
    edited August 2019

    moth, thanks for the video. Extraordinary and right up our alley

    Thank you.

  • ucfknights
    ucfknights Member Posts: 102
    edited August 2019

    santabarbian- what’s micromets? Like residual cancer left in the breast?

  • LoveMyVizsla
    LoveMyVizsla Member Posts: 813
    edited August 2019

    MountainMia, I had surgery first, then ACT, then a re-excision, then rads. My MO told me that my recurrence rate is 8-10%. I’m 3 1/2 years out.


  • MountainMia
    MountainMia Member Posts: 1,307
    edited August 2019

    LoveMyVizsla, I'm curious about your recurrence rate you site. Do you mean probability of recurrence? How was that determined?

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited August 2019

    ucfknights, yes, residual cancer that is too small to light up in the MRI. Live cells that survived the chemo.

  • moth
    moth Member Posts: 4,800
    edited August 2019

    LoveMyVizsla, I wonder how the MOs arrive at those #s.
    Recurrence rates for my stats on Predict are a bit higher & I had a smaller tumor https://breast.predict.nhs.uk/tool
    I like your numbers better :D

  • jrominger
    jrominger Member Posts: 349
    edited August 2019

    moth. So we go to the cancer treatment centers of America. Nat was found to have the BRCA2 gene. The CTCA geneticist stated that without a DMX Nat’s chance of recurrence was at 45%! But with the DMX she said it would be less than 5%! Our MOn concurred that the DMX is a must with BRCA2. I like the less than 5% if that is the case.

  • MountainMia
    MountainMia Member Posts: 1,307
    edited August 2019

    Friday night I met a gentleman from my community who is about 2 years since his diagnosis with TNBC. Of course I have all of you here, but this was the first time I've spoken IN PERSON with anyone who knows anything about TNBC (aside from medical personnel, of course.) We hugged, we hugged again, we hugged again. It was an oddly intimate moment. He is the friend of a friend, so I hope I'll be able to visit with him more.

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited August 2019

    Wow that's cool Mia!

  • VL22
    VL22 Member Posts: 851
    edited August 2019

    Hi all! I know I’m don’t comment a lot anymore but I follow many threads. This is the one I really depended on in the beginning. Two years ago this week I was doing AC chemo and losing my hair and my sh$t! Yesterday I said goodbye to my firstborn at college and cried. I saved the real sobbing for the shower!

    I was proud, scared, excited and sad. I will miss that kid so much, but I am so grateful that I am here experiencing these milestones. At the same time I grieve for those who will never have these experiences because of this monster of a disease. It was just such a tangle of emotions! I’m at the point where some days I don’t think about cancer. But I have days where the fear is a knot in my belly.

    “Don’t cry because it’s over, smile because it happened”. Dr, Seuss

    I tell myself this as I see the door closing on my son’s childhood.

    I just needed to get all that out!!

  • cc4npg
    cc4npg Member Posts: 764
    edited August 2019

    9 YEARS NED... I haven't posted in a long while, but I want to give hope to all those facing triple negative breast cancer. In two weeks, I'll officially be 9 years out. There have been a couple of scares, but both cases had absolutely nothing to do with cancer returning. When I first came here, I was terrified... looking for answers... looking for hope. In the time I was extremely active on this thread, there were only a couple of people who posted being several years out, and I was so very thankful to hear from them! So now, I'm one of them and I've vowed to post here once in a while as long as the good Lord allows me to walk this earth.

    For those going through this, PLEASE remember... there are thousands of us out there who have battled triple negative and are living full lives without cancer. The vast majority of us who are on the other side don't usually visit these sites but once in a great while. Tips for you... eat, sleep, PRAY, surround yourself with positive people, take vitamins that help ward off triple negative, DRINK PLENTY OF WATER, read up on YOUR diagnosis and educate yourself because that education is ammunition in fighting! I have faith in God, and I know He is always there to help me (as He will with each of you also). God gave me so many wonderful people to help guide me through cancer... from my church, to my docs, to THIS ONE WEBSITE... specifically this ONE thread. I pray for wisdom and comfort for each and every one of you going through this battle... including the spouses... hang in there... the sun will shine again.

  • santabarbarian
    santabarbarian Member Posts: 3,085
    edited August 2019

    Bravo VL22! It's a great moment of combined sadness and joy! Wishing your DS all the best in college!

  • PiperKay
    PiperKay Member Posts: 173
    edited August 2019

    I also have found someone IRL (Ha! I am now using millenial speak) who has TNBC. She is a lovely woman who visits the same winery that I do. In fact, one of the owners of the winery introduced us because we had both told her of our situations. The other woman is just a few months behind me in a very similar treatment program, so we've chatted often about side effects and other things. We both commisserated over not being able to enjoy the wine, but we still love the winery, the people, the live music and everything associated with it so we both still go. It is comforting to have a real person in person to make a connection with who has this same thing, even if it just making eye contact across a crowded room.

  • HockeyChick_CA49
    HockeyChick_CA49 Member Posts: 31
    edited August 2019

    cc4npg thank you for posting and congrats on 9 years. I finished Xeloda treatment 2 weeks ago and I'm really struggling. Terrified now that treatment is over that the cancer will come back. I'm having a really hard time not going to those dark places. I just don't think I will be one of the "lucky ones" that will survive this. I know I shouldn't think that way but its hard not to with all the scary information out there. I hate not having control over this.

    Anyone with advice on how to move forward and not let me brain got to those dark places, let me know. I find educating myself on this disease gives me more anxiety. The information is scary. I'm tired of hearing how prognosis is poor for TNBC.

  • KSteve
    KSteve Member Posts: 486
    edited August 2019

    HockeyChick - I wish there was a magic answer to help you, but for me, it just took time. You just finished treatment and now you feel like you're doing nothing to prevent it from coming back. I think it's just a natural part of the process. Those that have not experienced a cancer diagnosis firsthand don't get this part of the process (in my experience anyway). Once you're done with treatment, they think "oh good, it's all over now". But it's a real mental battle for a while. For me, time really helped. I am also just about 9 years out and now it's not the first thing to enter my mind when I have a strange symptom. Give yourself a break and allow your mind to work it's way through the recovery. Time will help.

    Hugs,

    Kathy

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