Is the most aggressive treatment plan?

Options
ninel
ninel Member Posts: 168
edited June 2014 in Triple-Negative Breast Cancer

My SNB results just came back and the one node they took out tested positive (although it can only be sen microscopically). This has bumped me up to a Stage IIb. My oncologist who is part of the Moffitt Cancer Center in Tampa and only treats young patients (most of which are triple negative) gave me a choice of having Neoadjuvant or adjuvant chemotherapy. I asked her if it was up to her which would she choose. She said neo because this cancer is so aggressive she wants to monitor it to make sure the chemo is in fact working.

I will be on 4 rounds of AC followed by 4 rounds of Taxol every two weeks followed by surgery (I decided on a bilateral mastectomy). And then 5.5 - 6 weeks of 5 daily treatments of radiation.

Does this sound right? Did anyone else go through the same treatment?

As a side note: My oncologist also gave me a nice long hug and kiss on my cheek. Told me I can totally beat this and its curable. I've never had a doctor be that affectionate and caring. It left me confident that this doctor really cares.

Ninel

· Share on FacebookShare on Twitter

Comments

  • FloridaLady
    FloridaLady Member Posts: 2,155
    edited July 2008

    Ninel...Greeting from your neighbor,

    I glad you are having a good experience at Moffitt.  I have been there for a couple consults and was glad I'm getting treated in Lakeland.(felt very impersonal to me)   My surgeon and onc also are the the best.  Isn't great there are good people to work in this difficult field.  As for your treatment plan, what you describe is pretty standard treatment for triple neg at your stage.  I hope you have very few side effects from chemo.  I know Moffitt has some wonderful support groups.   Will Dr Cox be your surgeon? He is head of surgery there and is a nice man.

     living in hope,

    Flalady

    · Share on FacebookShare on Twitter
  • smithlme
    smithlme Member Posts: 1,322
    edited July 2008

    Ninel,

    I, too am a triple negative. I was 47 with my first diagnosis, with no node involvement. After my mastectomy I had 4 rounds of AC followed by 4 rounds of Taxol, two weeks apart. I also learned to give myself Neupogen shots for 7 days following each infusion to build my white counts...

    Linda

    · Share on FacebookShare on Twitter
  • ninel
    ninel Member Posts: 168
    edited July 2008

    Hi FloridaLady,

    My breast surgeon is Dr.Cox's brother. He has his own practice.My oncologist is Dr.Minton and she is very selective and only takes young patients. She is very experienced with triple negative and that gives me comfort that I am getting the best treatment.

    One thing I am a little worried about and completely forgot to mention to the onc, is with this treatment plan I'm only getting chemo prior to surgery. Shouldn't I get some chemo after surgery too or is radiation enough?

    Ninel

    · Share on FacebookShare on Twitter
  • RuthS
    RuthS Member Posts: 16
    edited July 2008

    Ninel,

     I am so sorry you are in this boat with us.  I read your info with an unsettled feeling.  I was in your shoes last year.  I have 2 small children, a boy who was 5 in April and a daughter who will be one in August.  I received my dx at 36 weeks, had my mastectomy when she was 8 days old and started my chemo when she was 5 weeks old.  My surgeon was Dr John Cox of Tampa Breast Center.  He is fabulous!  I ended up with 3 positive nodes, therefore not able to do immediate reconstruction.  However he did such a good job, the scar is not bad at all and many other Doctors have commented on the excellent job and wanted to know who my surgeon was. I went through the same chemo treatment at you will except my was in 3 week intervals.  I did not have any issues.  I was lucky in that it and radiation were very uneventful for me.  I think having the children as a distraction and a huge reason to fight harder, really helped.  I feel for you not having family near and your husband traveling.  We were in the same situation, so I had friends and family come for the surgery and the weeks of my treatment.  I recently completed my 1 yr testing of blood work and PET scan, showing I am NED!   I am in East Lake Woodlands, so please let me know if I can be of help.

    · Share on FacebookShare on Twitter
  • Jule
    Jule Member Posts: 250
    edited July 2008

    Hi Ninel,

    I am getting chemo before surgery and then rads. My doc recommended it due to my age (almost 37).

    Sounds like you have a caring onc. Glad to hear.

      

    · Share on FacebookShare on Twitter
  • ninel
    ninel Member Posts: 168
    edited July 2008

    Hi Ruth,

    So am I correct in assuming you had your surgery prior to the chemo? With your surgery, did you get the skin sparing mastectomy or because your nodes were positive Dr. Cox couldn't do that? He's my breast surgeon too.

    When he did my SNB he thought the node was clear. We were on cloud 9. Now I don't know what my future holds again. This is so scary.

    Where is East Lake Woodlands? Your profile shows Oldsmar, is that where it is? I work on Sligh Ave... very close. 

    Ninel

    · Share on FacebookShare on Twitter
  • RuthS
    RuthS Member Posts: 16
    edited July 2008

    Ninel,

    I did have my surgery prior to chemo.  At the time, it was not even suggested to me to do Chemo first.  I am not sure if it was because I was pregnant, or what.  I was so overwhelmed, I didn't even know to ask.  We had just moved to Florida the month before, so we already had a lot on our plate.  It was originally to be a skin/nipple sparing mastectomy, but during surgery, the 3 nodes came back positive so he decided the safest route for me was to take the nipple too. I keep forgetting that there was also a second tumor hiding behind the original one. I think he is great in looking out for his patients, telling us how it is and what we really need to know. I feel he truly wants what is best for us. I am fine with how it turned out.  If you can say no boob looks nice, I think mine looks really nice Kiss  You are right that this is VERY scary, especially with small children to think of, but we just have to hang in there, be tough and beat the crap!  

    East Lake Woodlands in a subdivision in Oldsmar, near the Target at Boot Ranch, where East Lake Road and Tampa road intersect. Are you closer to the Tampa airport and International Plaza? 

    Ruth 

    · Share on FacebookShare on Twitter
  • KPolasek
    KPolasek Member Posts: 184
    edited July 2008

    Hi all!

    I was dx 10/22/07, lumpectomy 11/1 ... then saw a scary oncologist on 11/30 ... then found a better one.  My 1st oncologist was a nightmare .... he only wanted to give me 3 chemo treatments.  Beginning 12/26/07, my new onc gave me 4 treatments of Taxotere and Cytoxan ... each treatment 21 days apart.  It wasn't too bad ..... but every problem that one could have with chemo, I had.  The I started and had 33 treatments of radiation.  I have large breasts and my healing is not going as well as I had been led to believe.  It, like chemo, is different for each person. 

    Just last night I was reading through some of the reports on this website .... I was surprised to read that although all 3 receptors indicates that the cancer is aggresive ..... it seems to respond better to treatment.  That gives me hope for more days with my family and friends.  I refuse to live in fear ....

    I am a Hospice Chaplain and I see patients that have 6 months or less to live.  They have taught me to fight hard, find peace, live each day to the fullest, don't take for granted this precious gift called life.  I also have learned and completely believe that when my body dies that it is not the end but a new birth into a new life and an unlimited body/spirit :o)

    Don't let knowledge cause fear but gain an insight into how best to handle your situation.  No one knows your body better than you and no one can make your decisions for you.  Sometimes that is a lonely road ... but it can be empowering as well.  I told my general physician today that my 30 yr old daughter is frightened ... he assured me that cancer is curable when we make sure that we do everything needed to find it early and is not necessarily genetic.  I am in Texas and have MD Anderson at my back door which is where I will go if needed :o)   

    Know that I am praying for you. 

    Blessings,

    Kay

    · Share on FacebookShare on Twitter
  • FloridaLady
    FloridaLady Member Posts: 2,155
    edited July 2008

    ninel,

    I have seen Dr Minton also, but not at Moffitt, and yes she was very nice.  I see where you had 1/1 nodes...did they go back and check the next set of nodes?  Did you have lumph mapping done?  That is were they give you the blue dye in your breast.  I never seen so few nodes taken if one tested positive, this is why I'm asking.  See Ruth's nodes take out...I would ask if they didn't.

    They only give you a 2nd dose of chemo if you have high Grade and more node involvment. I think it has to be something like...20+ nodes, but I'm not sure.  What they do is let your get through the first round of chemo, surgery and rads and see how you respond.   I sure your will have COMPLETE response to treatment.  Wishing you and the other Tampa ladies the best!

    Living in hope,

    Flalady

    · Share on FacebookShare on Twitter
  • ninel
    ninel Member Posts: 168
    edited July 2008

    When the breast surgeon did my SNB he only took one out becuase the MRI showed no involvement and he told my husband the node looked clear so he assumed it was until we got the pathology results. If the node showed only microscopic traces could other nodes still be infected?

    They will give me neo adjuvant chemo so when I have my mastectomy surgery and they remove all the nodes they'll be able to tell if they are infected still or if they're not then maybe the chemo worked?

    Should I be getting another surgery to remove more nodes before chemo and surgery just to be sure? Would they do that?

    Ninel 

    · Share on FacebookShare on Twitter
  • FloridaLady
    FloridaLady Member Posts: 2,155
    edited July 2008

    Nope! Ninel, After chemo and surgery is just find.  I just wasn't sure if you had surgery first.  Nodes can jump and miss spots. Example number 3 has bc and 4,5,6 clean and number 7 has bc.  I kinda of strange how it works.  I'm glad they will check more.  But don't let them be to aggressive.  They will want to take as many as 25 and that set you up for a higher chance of lumphedema.  You are such a young lady and this is a pain the the ....  Your bc was found very early and lymph involvement is not the whole story for bc, it can also travel through the blood.  So save that arm to hug children and do all the little thing you have yet to experience in life. 

    · Share on FacebookShare on Twitter
  • ninel
    ninel Member Posts: 168
    edited July 2008

    Ruth,

    I live in the Land O Lakes area, but work in Tampa (It's close to the Hillsborough exit off the Veterans).

    Do you mind sharing your email address with so I can ask some more questions?

    Ninel 

    · Share on FacebookShare on Twitter
  • twink
    twink Member Posts: 1,574
    edited July 2008

    My treatment was identical with a couple of exceptions. First, I opted to have the SNB at time of surgery (bilat mast), following chemo (I did Taxotere instead of Taxol). Secondly I had 3 positive nodes (micro mets but....) and went on to do 4 Carboplatin before radiation.  Good luck with your treatment, it sounds fairly typical.

    · Share on FacebookShare on Twitter
  • ninel
    ninel Member Posts: 168
    edited July 2008

    FloridaLady,

    Who is your oncologist and is he/she experienced with triple negatives?

    · Share on FacebookShare on Twitter
  • FloridaLady
    FloridaLady Member Posts: 2,155
    edited August 2008

    The Watson Clinic (Center of Cancer Care and Research) and is connected to Moffitt.  They do consults with Moffitt without the big center in my way.  I have been treated at MD Anderson Houston and Moffitt and feel this man has been cutting edge all the way.  He gave me Avastin 2 1/2 years before the rest of the ladies where getting and out side of a trial.  MD Anderson is still playing with it in trials.  He also gave Carboplatinum two years ago and everyone laughed at him, and guess what... they are all fighting to get this combo.  But Ninel you need to talk to ladies who have used my surgeon Elizabeth Dupont she has a very large  following. She was Dr Charles Cox right hand lady before leaving Moffitt and consider the best in Florida. If you ask ladies about her, you get Dr Dupont and followed by "And I Love Her!".  She was one of the first few who did lymph mapping.  Dr Franco does handle a lot of triple neg ladies.,.there are no true specialist. Only doctor's who stay on top of research and have a clinic that let's them treat patients with the most update chemo's and treatments, and don't put research first and treatment second. He treats a LOT of breast cancer, but also treats other cancers, and this helps him to understand so much more than one small field of chemo's and treatments.  He is a very gentle and loving man.  He worries about his patient's so much.  I LOVE this clinic, and I have been around the block. They get a lot of Moffitt refugees, because they are tired of the big clinic feel and not enough attention.

    Let me know if I can help you in any way.  Best wishes.

    Flalady

    · Share on FacebookShare on Twitter
  • RuthS
    RuthS Member Posts: 16
    edited July 2008

    Ninel,

    I sent you a pm with my home email address.  Let me know how I can help! I can also share what I think with help during/after surgery when you have such small children.

     Ruth 

    · Share on FacebookShare on Twitter
  • ninel
    ninel Member Posts: 168
    edited July 2008

    FloridaLady,

    I forgot to mention that my surgeon is Dr. John Cox. He is Dr. Charles Cox's brother.

    · Share on FacebookShare on Twitter
  • FloridaLady
    FloridaLady Member Posts: 2,155
    edited July 2008

    I know John Cox also...but I wish you would talk to Dr Dupont while in chemo. (waiting for surgery)  Believe me girl..I can tell you that you would not look back.  You still could use her if you want and have your treatment's at Moffitt.  I know ladies who do that.  I know ladies who come from all over Florida to see her and think it was worth the trip. I don't mean to push... but this ladies is something else.

    Flalady

    · Share on FacebookShare on Twitter
  • ninel
    ninel Member Posts: 168
    edited July 2008

    You say Dr. Dupont is a breast surgeon? Do you have her information?

    · Share on FacebookShare on Twitter
  • FloridaLady
    FloridaLady Member Posts: 2,155
    edited July 2008

    I'm going to PM you her info.

    · Share on FacebookShare on Twitter

Categories