TRIPLE POSITIVE GROUP

Hello everyone. Im newly diagnosed with left sided breast cancer. I found out yesterday my tumour is triple positive. The biopsy said it was 5/9 on the noghtingham score - so grade 1 (mitosis was 1). I got no other info on it though.

It’s all so new and a bit overwhelming at the moment. Im 39. Married with three kids (14, 8, and 4). I work full time at a community college as a faculty. I also am a doctoral candidate. I meant to be finishing up my dissertation this summer, but that’s definitely not happening.

My surgeon shared the plan with me yesterday. I was paralyzed between a lumpectomy + radiation, Oncoplastic reduction + radiation, or unilateral mastectomy. The surgeon said we could start with a lumpectomy and then hop into chemo and gather more info to help me decide (genetics & sentinel nodes at least).

So far I don’t have a surgery date. The lumpectomy will be within 3 weeks. Then 5 weeks after that I will start chemo and herceptin. The resident said a year of chemo? I think it’s likely 4-6 months of chemo and a year of herceptin? But I don’t know much about that part until after. They also said 5-10 years of hormone blockers.

One question I am really wondering is what will work be like. My work is very supportive but I don’t know if I’ll be able to work during chemo? Any insights from anyone would be great.

Thanks for sharing your experiences. Reading through some of the post, especially survivors, has made me more hopeful.

1982M,

I also teach in higher ed, and I worked through chemo. However, my course load was 2-2, not 5-5, which is common in community colleges. Also, my department chair allowed me to ditch my committee responsibilities and let me work at home on the days I didn't teach. Finally, I located colleagues who were willing to pitch in and teach my classes if I couldn't. I never needed a substitute, but I felt I needed to be prepared, just in case.

That worked for me, but it wouldn't have worked for everyone. Some people get all the side effects; I was lucky and didn't get very many. You don't know how you'll react to chemo until you start treatment. Herceptin was not a problem for me at all; I had zero side effects from that.

I did choose lumpectomy because I didn't want to do reconstruction and because I didn't want to go flat. (Reconstruction can take multiple surgeries as Special K knows very well.) Recovery was fine; in fact, I taught classes the day after my lumpectomy. Again, I may be one of the lucky ones, so you never know.

I'm sure your dissertation committee will understand if you don't finish up this summer. I didn't undertake any research projects during my "breast cancer" year, and it was what it was. ((Hugs))

HI there 1982M!

You are at the scariest stage (the not-knowing). I had lumpectomy, 12 taxols and herceptin to round out the year, radiation and now on tamoxifen, so prob the same as what you'll be getting. I worked thru whole thing! I was fearing the worst, and at least for me, it was not terrible. I even requested a stand-up desk at the hospital and worked DURING chemo. You can do it! ; )

Racheldog - I have had 3 herceptin (kanjinti) only treatments and other than being a little tired I’ve had no side effects.

Thank you both on the last two entries. You are making me feel better about Monday not being "D" day or incapacitated. Appreciate the experiences of others. I was sick Kadcyla which really spooked me for Herceptin. Thank you.

Hi, Everyone, I had my lumpectomy and removal of 6 lymph nodes on Tuesday. My pathology report came back today. The TCHP definitely worked, I now only have residual disease in one of the nodes. It was all gone from the tumor and other nodes. I’m assuming that means Kadcyla with the HP next. I see my oncologist on Monday.

One question: when I was first biopsied, I was strongly HER2 positive. Now pathology is saying my HER2 status is “equivocal.” I believe they are forwarding a specimen for additional testing, but can anyone tell me anything more? Can this status change as a result of treatment? If I’m no longer HER2 positive, how does this change treatment moving forward? I’m trying not to worry about it all weekend! Thank you!

I am just a few months shy of being cancer free for six years..until I found a tiny lump in my armpit. I went today for a mammogram on that side, ultrasound and biopsy for a 1 cm mass that looks like metastasis. I was only able to take aromatase inhibitors for three years before the began affecting my liver. Needless to say, I am worried and a bit discouraged

Thanks Elaine—I wrote that a few days ago, and I’ve since had time to learn more. My doctor explained that there’s not always consistent expression of the HER2 across any particular sample. She sent it for the FISH test, and I got it back today. It’s still positive. I really appreciate your responding to me!!

Gamzu—I’m so sorry you are going through this. It IS incredibly shocking. I started this process in February, and I’m still dipping in and out of shock. I have found this forum to be so incredibly helpful and supportive. I hope you will as well. And, I’m sorry that you (well, any of us!) have to be here.

CreativeVintage—I hope your results come back quickly and that the findings bring you peace. I’ll be thinking of you.

JamG,

Special K often recommends taking I-glutamine for neuropathy. As she wrote in another post, "I took 30g daily during my 6 TCH infusions, but it was dissolved in a cold non-acidic drink first. I also took B6 at the same time."

I myself never iced while on Taxol, but never really got serious neuropathy.

gamzu, barbojoy - I was also terrified of chemo, but it turned out to be just not that big of a deal. I think the anxiety was waaaay worse than the actual treatment. My appetite didn't suffer, but my tastes did change as I started getting weird tastes in my mouth with the later infusions. On steroids I was starving all the time. I mean, two trips to Taco Bell before noon starving. I worked except for chemo days because chemo took all day, I worked out 5x/week. I was tired sometimes but still could do normal things, even on the days that were supposed to be the worst. I had to stay out of the sun because I'd get weird rashes, but still went running and hiking, I just had to cover up. Good luck, join a chemo thread, YOU WILL GET THROUGH THIS!!!

thank you, Hap

1982M,

1) Yep, I'm highly ER+/PR+ (95%). However, chemo cleared out all the active cancer in my breast and compromised lymph node, so I'd say it didn't make a difference in my case.

2) As JamG learned, one's cancer can be heterogenous. Just because the sample taken for you biopsy was Grade 1, that doesn't mean that your cancer is consistently Grade 1. Some parts may be Grade 2. Yes, chemo works best on quickly dividing cancer (Grade 3), but that doesn't mean that it won't have any impact on any rogue cells circulating through your lymph system or bloodstream.

3) No, all triple positives don't get the same treatment. Increasingly, for small tumors like yours, triple positives do Taxol + Herceptin (and possibly Perjeta). For bigger tumors, the two most common treatments are Taxotere + Carboplatin + Herceptin + Perjeta OR Adriamycin + Cytoxan, then Taxol + Herceptin + Perjeta. You may have less access to Perjeta because you're in Canada.

Good luck with your surgery!

Creativevintage - and others awaiting results, sending positive vibes your way. Waiting for test results is hard. I found that keeping busy on other things helps to keep my mind occupied.

gamzu710 - best of luck as you begin you treatment journey. Increasing your protein might help you to maintain weight if you start to drop too much weight. Many centers have nutritionists available to consult on specific dietary needs.

I'm having a diagnostic mammogram on Tuesday, less than 2 weeks out from my lumpectomy. How bad is this going to hurt? It wasn't a huge amount of tissue removal but there's a tender area of hardness around the incision site and a collection of blood that gravity has sent to the bottom of that breast that's making interesting colors. I've never had a mammogram before (which I realize sounds odd on this forum; my diagnosis process has been a bit backwards) and I can't imagine that squeezing my breast hard in this state isn't going to hurt a LOT. And that whatever hematomas or blood are collected in there are going to mess with the imaging. Am I wrong?

I cannot imagine why two weeks out you are having a diagnostic ? Why not an ultrasound? Perhaps a seroma that could be evacuated by your surgeon?