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Topic: Response to neoadjuvant chemo?

Forum: Stage III Breast Cancer — You are not alone. Meet others who have Stage III breast cancer.

Posted on: Sep 11, 2016 10:00PM - edited Sep 11, 2016 10:00PM by Mom_of_twins

Mom_of_twins wrote:

Hi everyone! I'm just curious about your response (particularly for anyone who was ER+) to neoadjuvant chemo. I still had residual cancer in breast and nodes after chemo, and am concerned. I'm stage IIB, but could be IIIA as we don't really know how many nodes were initially involved due to the NAC.

If you don't mind, could you please share your clinical stage and the results of your pathology after chemo? If you had residual disease, did they give you additional treatment (e.g. more chemo) or did you participate in any clinical trials?

Thanks so much!!

Dx 1/6/2016, DCIS/IDC, Left, 2cm, Stage IIB, Grade 2, 2/5 nodes, ER+/PR+, HER2- Chemotherapy 2/4/2016 AC + T (Taxol) Surgery 6/14/2016 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Radiation Therapy 7/18/2016 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 9/29/2016 Arimidex (anastrozole), Zoladex (goserelin)
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Jul 26, 2017 01:50AM Momy4ever wrote:

Hi Mom of twins, I just finished yesterday my 6th and last Xeloda cycle. Will have pet scan in 2 weeks... so scared but hopefull.

Dx at 41 Dx 8/16/2016, IDC, Left, 6cm+, Stage IIIC, Grade 3, 11/20 nodes, ER-/PR-, HER2- Chemotherapy 8/21/2016 AC + T (Taxotere) Surgery 1/5/2017 Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Radiation Therapy 3/28/2017 Whole-breast: Breast, Lymph nodes
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Jul 26, 2017 06:09AM Momine wrote:

I had neo-adjuvant FEC, with a lobular stage 3 DX. The tumor shrank rapidly during the FEC. After 2 treatments it was halved, and after 4, we couldn't find it. However, on path, they still found active tumor, 18X2 millimeters, so basically a sheet of cancer. There were also 7 positive nodes. I then had 4 treatments with taxotere, followed by heavy radiation. For what it is worth, that was 6 years ago.

Dx 6/1/2011, ILC, 5cm, Stage IIIB, Grade 2, 7/23 nodes, ER+/PR+, HER2- Chemotherapy 6/19/2011 Cytoxan (cyclophosphamide), Ellence (epirubicin), Fluorouracil (5-fluorouracil, 5-FU, Adrucil), Taxotere (docetaxel) Surgery 9/12/2011 Mastectomy: Left, Right Radiation Therapy 1/8/2012 Surgery 3/7/2012 Prophylactic ovary removal Hormonal Therapy 3/31/2012 Femara (letrozole)
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Jul 26, 2017 08:00AM meg2016 wrote:

Thank you Momine, that's so great to hear!

Doing well here, I pushed my exchange surgery to fall to travel and spend more time with kids this summer, also to try to get stronger to hopefully make recovery easier this time. Having surgery after chemo was a slow recovery... I couldn't believe how weak I had gotten. Getting core strength so I can sit up after surgery without help, lol.

Diagnosed 3/4/16 at age 39; 2cm, Stage IIIA, Grade 3, 6/11 nodes, ER+/PR+, HER2+ , THP+AC, DMX with expander placement, Radiation, Aromasin
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Jul 26, 2017 09:26AM Momine wrote:

Meg, yes, I did not have recon. Initially because my doctor asked me to delay all together. His concern was that if I got an infection, for example, it could delay or interrupt chemo. Also, he was concerned about the beating I would take, and as you have discovered, he had a point. Anyway, it ain't fun, but you will get through it.

Dx 6/1/2011, ILC, 5cm, Stage IIIB, Grade 2, 7/23 nodes, ER+/PR+, HER2- Chemotherapy 6/19/2011 Cytoxan (cyclophosphamide), Ellence (epirubicin), Fluorouracil (5-fluorouracil, 5-FU, Adrucil), Taxotere (docetaxel) Surgery 9/12/2011 Mastectomy: Left, Right Radiation Therapy 1/8/2012 Surgery 3/7/2012 Prophylactic ovary removal Hormonal Therapy 3/31/2012 Femara (letrozole)
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Aug 9, 2017 10:44AM ajbclan wrote:

Hi! Well it's my "cancerversary" today.....1 year since diagnosis. So thankful for this site that helped me get through all the crap we deal with. Will celebrate with a blood draw for my MO appt next week lol.

All is going....Tamoxifen seems to be ok for me, but we will see what she says at the 1 year marker (she talked about changing it). I'll have my "exchange" surgery in Sept so 1 more thing to do.

I had that variance on the PALB2 gene, and no word on that yet either.

I guess quiet is good right now! Wishing you all well...

Dx 8/9/16 with "multiple masses", chemo from 8/24/16 to 12/14/16- PCR! BMX 1/31/2017. Dealt with a blood clot and cellulitis. Wife of 19 years, mom to a 14 year old daughter and a 5 year old English Mastiff! Dx 8/9/2016, IDC, Right, 4cm, Stage IIA, Grade 3, 0/2 nodes, ER-/PR+, HER2- Chemotherapy 8/24/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 1/31/2017 Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 3/19/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Aug 10, 2017 06:02PM Kicks wrote:

Congratulations on a year! Yestsrday (Aug 8) was 8 yrs for me so I wish you as many more years (and then many more) as I have had and still NED.

Dx 8/7/2009, IBC, Stage IIIC, 19/19 nodes, ER+/PR-, HER2- Chemotherapy 8/24/2009 AC Surgery 10/20/2009 Lymph node removal: Right; Mastectomy: Right Chemotherapy 11/10/2009 Taxol (paclitaxel) Radiation Therapy 2/3/2010 Breast, Lymph nodes
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Aug 10, 2017 10:15PM Mom_of_twins wrote:

Hi guys! I was on vacation, so trying to catch up on posts!!

Momy4Ever, did you have your PET scan yet? If so, how did it go?? Thinking very positive thoughts for you. So happy you finished Xeloda; I hope it went smoothly for you.

Momine and Kicks, thank you for sharing! Your stories are so inspiring and give us so much hope. Kicks, have you been on hormonal therapy this whole time? If so, which regimen?

Meg, so glad to hear you're doing well! I don't blame you--there's too much fun stuff going on during summer to plan a surgery! Do you have a date scheduled yet for the fall?

Ajbclan, congrats on one year! Here's to many, many more!!

Hope everyone else is doing well! I've been super busy--went on a few fun trips this summer and now it's just non-stop at work. Despite being busy, I still think and worry about BC every day. Still can't shake that feeling of being doomed for a recurrence and the positive nodes still haunt me. Pretty much why I started this thread in the first place! Hope it gets easier with time. I catch myself getting really nervous to make long-term plans. Hate that. Just trying to take it one day at a time.


Dx 1/6/2016, DCIS/IDC, Left, 2cm, Stage IIB, Grade 2, 2/5 nodes, ER+/PR+, HER2- Chemotherapy 2/4/2016 AC + T (Taxol) Surgery 6/14/2016 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Radiation Therapy 7/18/2016 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 9/29/2016 Arimidex (anastrozole), Zoladex (goserelin)
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Aug 10, 2017 10:28PM Kicks wrote:

I started Femara 2 weeks after last Taxol (a week after starting rads). At that time Femara was only available as Femara (brand name). When it became available in generic form, letrozole. Since then have been on generic letrozole.

Dx 8/7/2009, IBC, Stage IIIC, 19/19 nodes, ER+/PR-, HER2- Chemotherapy 8/24/2009 AC Surgery 10/20/2009 Lymph node removal: Right; Mastectomy: Right Chemotherapy 11/10/2009 Taxol (paclitaxel) Radiation Therapy 2/3/2010 Breast, Lymph nodes
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Aug 11, 2017 09:55PM Mom_of_twins wrote:

Thanks, Kicks! Do you have any knowledge regarding the efficacy of the different AIs? My MO said it doesn't really matter, and she preferred I start with Anastrazole. Wondering if I should push to be switched to Letrozole? I've read some studies that it's marginally more effective. I just want to do everything I can.

Also Kicks, I see you are PR-. Prior to chemo I was weakly PR+ and after chemo I was PR-. Any information regarding what that means? I've read that it might mean I might be resistant to antihormonals. Your story certainly gives me tons of hope. Thank you!!

Dx 1/6/2016, DCIS/IDC, Left, 2cm, Stage IIB, Grade 2, 2/5 nodes, ER+/PR+, HER2- Chemotherapy 2/4/2016 AC + T (Taxol) Surgery 6/14/2016 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Radiation Therapy 7/18/2016 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 9/29/2016 Arimidex (anastrozole), Zoladex (goserelin)
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Aug 12, 2017 03:50AM Traveltext wrote:

Congrats Kicks 08/08 and 8 years NED. The Chinese love a row of eights and would go out and buy a lottery ticket. I'm now 3 years NED post treatment.

Momine, I had the same treatment as you and after a couple of FECs the tumor was "gone". But no, it was still here at post op path. Hoping the rads zapped the remnants.


Have breast & prostate cancer. NED both. More on Male BC

Dx 03/14, IBC, L. 2cm, S IIIB, G 2B, ER+/PR+, HER2- FEC x3, Taxol x3

Mx & 2/23 nodes 07/14

Rads x 33 09/14 and now on Tamox

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Aug 13, 2017 01:30AM gocancergone wrote:

Mom of twins, I had quite a bit left over. I was clinical 3C with rotter and intramamary node involement along with multiple matted axillary. They thought I was multicentric as well. Turns out my cancer looked like a big cauliflower or broccoli head and the chemo plus keytruda ( I was on a trial) knocked off the heads but not the base. I was left with a 10.3 cm mass and 3 positive nodes. Rotters was not visible on last MRI and my surgeon did not want to take it, and they leave your intramammary alone. Last PET back in November gave me the all clear. I found a calculater by MD Anderson of great help for us neoadjuvant group with residual cancer. Can't post it here though. Oh and my pr status was a 90% prior to chemo and 2% after. My MO said it just happens and is not something they worry about. Im at UCSF in the SF bay area so I feel a fairly good hospital.


Dx 3/3/2016, IDC, Right, 6cm+, Stage IIIC, Grade 2, 3/13 nodes, ER+/PR+, HER2- Chemotherapy 4/25/2016 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxol (paclitaxel) Surgery 10/5/2016 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right; Reconstruction (right): Tissue expander placement Radiation Therapy 11/15/2016 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 2/1/2017 Femara (letrozole) Surgery 7/20/2017 Reconstruction (right): Fat grafting, Silicone implant Hormonal Therapy Aromasin (exemestane)
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Aug 15, 2017 10:32AM ajbclan wrote:

Hi All-

I have an appt for Thurs for regular follow up with MO, but the blood work came through this am. White Cell, Platlet and one other low. Of course I google and now worry. I've messaged my dr - geez I just want to move forward.


Dx 8/9/16 with "multiple masses", chemo from 8/24/16 to 12/14/16- PCR! BMX 1/31/2017. Dealt with a blood clot and cellulitis. Wife of 19 years, mom to a 14 year old daughter and a 5 year old English Mastiff! Dx 8/9/2016, IDC, Right, 4cm, Stage IIA, Grade 3, 0/2 nodes, ER-/PR+, HER2- Chemotherapy 8/24/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 1/31/2017 Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 3/19/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Sep 26, 2017 10:29AM Roisin wrote:

Hi Mom of twins...our story appears similar. I am stage 2b grade 3 with 2 positive nodes, ER+ and PR+. I did chemo first - 4 AC and 4 Taxol. Then i had a lumpectomy and got clear margins. Once we seen the pathology report it appeared that the tumor actually only had a tiny response to chemo. The tumor was initially 3.3cm and after chemo it was 3cm but the nodes showed good response.

I am on tamoxifen and zodalex and about to start rads.

I am so scared this has made my prognosis worse than i imagined.

Have you any information or advice from your experience ?

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Sep 26, 2017 08:34PM lily2 wrote:

Hello everyone, although I am not er+ I had a complete responce to neoadjuvant chemotherapy .I was told that I had axillary and internal mammory nodes involved from petscan but none were ever biopsied. They did however show up clear on the breast mri I had after my 5th treatment.it also showed residual cancer in my breast but final pathology showed no cancer just benign calcifications and inflammation with a big scar from the initial biopsy 5 months prior.

Dx 2/27/2017, IDC, Right, 4cm, Stage IIIA, Grade 2, 0/2 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 3/21/2017 Herceptin (trastuzumab) Chemotherapy 3/22/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 7/31/2017 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy
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Sep 26, 2017 10:01PM Mom_of_twins wrote:

Roisin, yes, we definitely were in a similar boat. It's just so disappointing when you think you had a great response, to only find out that chemo didn't do as much as we'd hope. Obviously, it wouldve been better prognostically if we had a complete response; but from what I'm told, that's fairly uncommon for strongly ER+ patients. I've been told by several, reputable MOs that hormonal therapy is our best defense.

Lily2, congrats on a complete response. Amazing news!!

Ajbclan, sorry I missed your post somehow! I'm sorry to hear about blood work. What did your doctor say? My levels have been low since chemo, too. Starting to think it's just my new normal.

Gocancergo, thanks for sharing! Interesting that your PR level was lower after chemo, too!

Dx 1/6/2016, DCIS/IDC, Left, 2cm, Stage IIB, Grade 2, 2/5 nodes, ER+/PR+, HER2- Chemotherapy 2/4/2016 AC + T (Taxol) Surgery 6/14/2016 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Radiation Therapy 7/18/2016 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 9/29/2016 Arimidex (anastrozole), Zoladex (goserelin)
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Sep 27, 2017 08:03AM - edited Sep 27, 2017 08:53AM by lily2

Thanks mom of twins!! I can tell you I really wasn't expecting a pcr.I don't think my MO expected a pcr due to the extent of cancer in my breast and lymph nodes,my original plan was a radical mastectomy with full axillary removal, but ended up having a quadrantectomy with 2 sentinal nodes removed.I'm still in disbelief and think they missed something on pathology but I need to get over it and think positive with having such good results.lol

Dx 2/27/2017, IDC, Right, 4cm, Stage IIIA, Grade 2, 0/2 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 3/21/2017 Herceptin (trastuzumab) Chemotherapy 3/22/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 7/31/2017 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy
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Oct 2, 2017 09:59PM meg2016 wrote:

I have been doing some reading lately on PCR as a predictor of recurrence, it seems that particularly in triple positive and also in high ER/PR cases it isn't quite as good an indicator. I suppose that makes me feel a little better. I'm headed into my exchange surgery next week so I have things I worry about other than that for the immediate future. Then I can go back to worrying about recurrence. :) Hope everyone is doing well!

Diagnosed 3/4/16 at age 39; 2cm, Stage IIIA, Grade 3, 6/11 nodes, ER+/PR+, HER2+ , THP+AC, DMX with expander placement, Radiation, Aromasin
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Oct 3, 2017 08:19AM Mom_of_twins wrote:

Thanks for sharing that, Meg!! Good luck with your exchange surgery...let us know how it goes!

I've been especially worried about recurrence lately. Ugh.

How's everyone else?

Dx 1/6/2016, DCIS/IDC, Left, 2cm, Stage IIB, Grade 2, 2/5 nodes, ER+/PR+, HER2- Chemotherapy 2/4/2016 AC + T (Taxol) Surgery 6/14/2016 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Radiation Therapy 7/18/2016 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 9/29/2016 Arimidex (anastrozole), Zoladex (goserelin)
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Oct 4, 2017 08:08PM reflect wrote:

Hi Meg and Mom, I sometimes go down that dark road wondering about recurrence, mets, but I have a full and busy life going on here and it's a great distraction. I am also planning regular family happenings to build good memories, and that has been fun and feels like a positive thing I can do for the future. My perspective has certainly shifted.

Hormonal Therapy 9/20/2015 Arimidex (anastrozole) Radiation Therapy 10/1/2015 Breast, Lymph nodes Dx 2/3/2016, DCIS/IDC, Right, 1cm, Stage IIIA, Grade 2, 7/17 nodes, ER+/PR+, HER2- Chemotherapy 2/25/2016 AC + T (Taxol) Surgery 9/13/2016 Lumpectomy: Right; Lymph node removal: Sentinel, Underarm/Axillary
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Oct 4, 2017 10:07PM Mom_of_twins wrote:

reflect, I feel the exact same way. Thankfully, life is so full and busy that I’m forced to focus on other things. So glad to hear you’re doing well

Dx 1/6/2016, DCIS/IDC, Left, 2cm, Stage IIB, Grade 2, 2/5 nodes, ER+/PR+, HER2- Chemotherapy 2/4/2016 AC + T (Taxol) Surgery 6/14/2016 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Radiation Therapy 7/18/2016 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 9/29/2016 Arimidex (anastrozole), Zoladex (goserelin)
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Oct 12, 2017 03:57AM meg2016 wrote:

Had my exchange yesterday. So far not much pain despite quite a bit of work on my radiation side. Can't really tell cosmetic result yet, but they feel a lot better than the expanders! Also seeing my MO this week, will ask as always about any new drug options  for recurrence/side effects, we talked a little about Prolia last time. If I hear anything I'll report back.

Diagnosed 3/4/16 at age 39; 2cm, Stage IIIA, Grade 3, 6/11 nodes, ER+/PR+, HER2+ , THP+AC, DMX with expander placement, Radiation, Aromasin

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