Disappointed with chemo response to TNBC

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ClareSim19
ClareSim19 Member Posts: 11
edited November 2020 in Chemotherapy - Before, During, and After

Hi,

my mum was diagnosed with triple negative breast cancer in July. Her tumour was 5cm and 2 positive lymph nodes under arm.

She had 9 x weekly PC chemo and has had 2 out of 3x EC chemo, with the last one due in a few weeks.

She had an mri scan after the 7th weekly PC chemo and today she received the results.

Sadly, the scan only showed a 5mm shrinkage of the tumour. There was talk of the volume within the tumour reducing , but not too sure what this would indicate.

It could have been worse news, but we are very disappointed as we were hoping for more shrinkage after 7 weeks of chemo, especially as I had heard that triple negative cancer responds well to chemo.

Any words of encouragement or advice?

Thanks x

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited November 2020

    Hi!

    Scans can be misleading! The truth will be in the pathology report that your Mom gets after surgery. Also, sometimes, what appears to be the tumor on a scan is just a remnant of the tumor. Another BCO.org member once said that the tumor dissolves into something resembling Swiss cheese, so what appears to be solid tumor is often just a "hole." ((Hugs))

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  • ClareSim19
    ClareSim19 Member Posts: 11
    edited November 2020

    Hi Elaine,

    Thankyou for replying!

    We are just a bit disappointed as I have read lots of stories about how a lot of people’s tumours have shrunk to half during chemo and that triple negative is supposed to respond quite well,

    However, as you rightly say, scans can be misleading and the truth will be in the pathology report.

    I will remember the Swiss cheese :-) xx


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  • Moderators
    Moderators Member Posts: 25,912
    edited November 2020

    Welcome, ClareSim19! We know it can be disappointing, but as ElaineTherese said, there's much to be learned from the pathology report! We hope your mum is tolerating chemo well, and please do keep us posted when you learn more.

    The Mods

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  • ShetlandPony
    ShetlandPony Member Posts: 4,924
    edited November 2020

    Clare, I don’t know a ton about TNBC, but it sounds like your mum had Neoadjuvant chemo (before surgery). I assume that after surgery they will give her another chemo from a different class, and the cancer may respond better to that one. If chemo #1 was not effective enough, it is good to know that, so they can use a different chemo next. Sometimes they give the pill chemo Xeloda/capecitabine. Also, if the response to this first chemo is not as good as expected, ask if they did the most sensitive test for Her2. If the cancer is actually Her2+ , they can add a Her2 drug like Herceptin, which is typically very effective.

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  • ClareSim19
    ClareSim19 Member Posts: 11
    edited November 2020

    Hi ShetlandPony,

    yes that’s correct, it’s chemo before surgery. No one has mentioned more chemo after surgery, but I did wonder if this would be a possibility.

    She has a telephone appointment with her oncologist two days before her last chemo (no face to face appointments due to covid), so we are hoping to get better clarity and more information regarding these scan results. She is under Christie’s so I would like to think they know what they are doing :-/ but I will make a note and remember to ask during her telephone appt re sensitive test for Her2+.

    I did see on her notes that it said “ ER2, PR0, HER2 2+ not amplified ki67 37%.Malignant axillary lmphadenopathy” I’ve no idea what any of that means...Not sure if that sheds any light on what you mentioned regarding Her2+.

    I have been worrying that if there isn’t much shrinkage, is it more difficult to get clear margins during surgery and it has also been on my mind that if her tumour hasn’t responded well to chemo, then any rogue cells that are going through her body, will they have not been killed. She’s only 52. Cancer is difficult enough without facing the possibility that the chemo may not be working very well. But we will see and cross our fingers.

    Thankyou for your helpful reply x

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  • ShetlandPony
    ShetlandPony Member Posts: 4,924
    edited November 2020

    If a breast cancer is not responding well, and has a high Ki67, one wonders if its Her2 has been accurately assessed. From the BCO page: “If the score is 2+, it's considered borderline. A score of 3+ is considered HER2-positive. If the IHC test results are borderline, it's likely that a FISH test will be done on a sample of the cancer tissue to determine if the cancer is HER2-positive.“ Maybe they did do FISH or even CISH, but I would make sure. If you want to post your mom's “stats" to tell us more about diagnosis and treatment, that might be helpful.

    BCO page about Her2 testing

    https://www.breastcancer.org/symptoms/diagnosis/her2


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