72 year old Lady with 2cm lump TNBC- Have questions

Hi Ladies.

I am hoping so much you gals can help me answer some questions. I am a 5 year survivor of HER2 breast Cancer so I have been here for 5 years but this new series of events have left me stumped.

Let me give you the stats and I am hoping that some ladies will jump in. Please please

My MIL is 72 and has colitis, and osteoporosis. She is on a special diet ( gluten free/low fodmap) diet and has a rotator cuff that gives her a lot of pain. She is thin and independently living in a home near her two sons ( I am 6 hours away but very close friends with her).

Two weeks ago she went for a mammogram and they found a small lump( 1.2-2cm) her nodes don't feel swollen but she had the lump for 2 months before she could get in because of Covid. It is Grade 3 and I am assuming Stage 1-above her nipple near the surface. Initially before the biopsy results they were suggesting she have a lumpectomy and then radiation. She meets with the MO and the Rad specialist Monday. Well today they told her it is triple negative. I am wondering what the course of treatment is "likely " they will recommend? They are right now thinking Lumpectomy and then I am assuming radiation and now assuming chemo but I don't know how the usual path of treatment for that.

She is totally willing to get a mastectomy if it means that she will avoid radiation or improve her outcome because she would rather just get on with life. Could she likely avoid radiation if she has a mastectomy? I just don't know how hard radiation would be on her because I had chemo and a mastectomy.

Also if they say she needs Chemo which chemo do they usually prescribe? I want to get an idea of what it would look like and I am not going to her appts with her as she has my SIL going but then I need some context to know what she is talking about.

My mom is 73, also has colitis, is very thin, and has osteopenia. Last year she had triple negative BC, and she was treated with AC + Taxol, Lumpectomy and 4 wks radiation. It was all unpleasant for her, neulasta was hardest, in so far as feeling really miserable, and keeping weight on was a struggle, but she's coming up on a year out from treatment and tired but ok.

I had triple positive the year before and I was told if your nodes are negative, lumpectomy + radiation = BMX but I don't know if they apply that to triple negative. My mom didn't want to get BMX surgery so we didn't ask. From reading posts here, AC + Taxol seems like the most common triple negative chemo.

thanks for.your response..ehat order did she have the treatment? Did she do rads first? How.did she fair with rads?

She had her lumpectomy first, which I don't think is always recommended, then she had 4 infusions of AC spaced 2 weeks apart, then was supposed to be 12 weekly taxol and she only did 10, (it was getting really hard on her and we saw info that 10 is very close to as effective), then a couple of weeks to rest, then radiation. She did well with rads, it was tiring but she was not as generally yucky feeling as she was with the chemo. Rads were every weekday, but it was only about a 30 minute appointment and she drove herself (she was staying with me and I live 5 minutes from the cancer treatment center, really lucky in that way). In her experience rads were the 2nd easiest part (after surgery) - not bad at all.

Her colitis didn't seem to be made worse by any of the treatments. To top it all off she had an ablation for atrial fibrillation about 2 weeks after finishing radiation then I took her home to northern California the weekend before the Covid shutdown began. It was quiet a year.

My chemo for TNBC was taxotere and carboplatin.

Carboplatin is considered good for high grade TNBC. Not a horrible chemo as chemos go (only 6 x) I was able to deal with most SEs by fasting prior to chemo. Only the last two rounds were rough due to fatigue/anemia.

Carboplatin and Taxotere usual for Her2 (w HP).

(If they suggest chemo)

Lx + rads = Mx.

Remind her: lymphedema is no picnic... Mx not necessarily "no more issues."

But if she's thin, she is lower risk for lymphedema.