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Topic: Oncologist said no chemo needed !( confused )

Forum: Triple-Negative Breast Cancer —

Share with others who have ER-/PR-/HER2- breast cancer.

Posted on: Jun 24, 2021 07:41PM - edited Jun 24, 2021 07:42PM by Calvin71

Calvin71 wrote:

I had my pathology reports yesterday and the surgeon told me due to the size of the mass which is 7 mm and it has not gone to my lymph nodes that I will not be needing chemo and just only surgery. I am puzzled because it is triple negative. Did anyone experience this ? I have a second opinion tomorrow.

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Jun 24, 2021 08:00PM jhl wrote:

Calvin,

Are you seeking this out for your wife Bikegal? You write in the first person but from previous comments, the individual with cancer is your wife. Is that correct? This is a question that cannot be answered unless we have more information. By any chance, is English your first language?

Dx 11/15/2019, IDC: Cribriform, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- (FISH)
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Jun 24, 2021 10:11PM Calvin71 wrote:

Wife ? This questions is for me .I’m a female . I’m totally puzzled by this entire message . Yes I speak English . It’s my first language .

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Jun 24, 2021 10:39PM jhl wrote:

Calvin,

I so apologize. From a previous thread, it appeared you were speaking on another's behalf. I was confused.

Can you be more specific about your pathology? Hormone receptor signaling, HER + or -? Stage and Grade of surgical pathology? Could you give us more to go on?

Again, I do so apologize,

Jane



Dx 11/15/2019, IDC: Cribriform, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- (FISH)
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Jun 24, 2021 10:50PM Beesie wrote:

Calvin, here are the current NCCN guidelines for triple negative. For a 7mm tumor, it says to "consider chemo" but chemo is not firmly recommended in all cases, as it for tumors over 1cm in size.

How old are you? If you are older, that could be the reason for the "no chemo" recommendation, if you see footnote cc.

Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole
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Jun 24, 2021 11:00PM Cowgirl13 wrote:

Definitely see an oncologist. Chemo is not the purview of a surgeon.

Be the kind of woman that when your feet hit the floor each morning the Devil says: 'Oh crap! She's up! Dx 5/28/2009, IDC, Left, 2cm, Stage IIA, Grade 3, 0/4 nodes, ER+/PR+, HER2+ Surgery 6/17/2009 Chemotherapy 8/3/2009 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 12/21/2009 Hormonal Therapy 2/23/2010 Arimidex (anastrozole)
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Jun 24, 2021 11:09PM Calvin71 wrote:

Hi . I am 57. It’s triple negative on my good breast as I had TN on my other breast in 2012. Grade 3.

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Jun 24, 2021 11:14PM Calvin71 wrote:

it’s ok ! So far stage 1, triple negative , 7mm tumor . Grade 3. No nodes seem to be involved . No lymphovascular invasion .

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Jun 24, 2021 11:18PM jhl wrote:

Hi again Calvin,

Have you been referred to a medical oncologist (MO)? I agree with Cowgirl, a surgeon is not the decision maker on who does or does not need chemo. Have you followed the NCCN guidelines? https://www.nccn.org/patients/guidelines/content/P...


Dx 11/15/2019, IDC: Cribriform, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- (FISH)
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Jun 24, 2021 11:22PM - edited Jun 24, 2021 11:25PM by Calvin71

This Post was deleted by Calvin71.
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Jun 24, 2021 11:25PM Calvin71 wrote:

Tomorrow I meet with other team of doctors that I have personally chosen . Oncologist, surgeon and plastic surgeon . Totally different hospital . I chose them each based on their background 2 are formally from Hopkins . Let’s see what they have to say and their plan

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Jun 24, 2021 11:27PM Calvin71 wrote:

thank you !

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Jun 24, 2021 11:34PM jhl wrote:

Calvin,

Thank you! If you are meeting with Hopkin's cancer physicians, they are at a NCCN hospital so they are very up to date on the latest research. This is a tough time with more questions than answers. I'd encourage you to read, particularly folks who have a similar kind of pathology. Read & write down your questions. Ask lots of questions. Is there anyone who can go with you to your second opinion who can take notes while you try to absorb the info you are being given. You should be able to access your clinical information online - that is a new law as of 2021. However, if you feel you cannot find it, be sure to ask for a paper copy of your pathology, surgical record & recommendations.

Best of luck tomorrow,

Jane

Dx 11/15/2019, IDC: Cribriform, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- (FISH)
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Jun 24, 2021 11:39PM ShetlandPony wrote:

You are fairly young, it is grade 3, and this is your second breast cancer. I would not be surprised if the medical oncologist is in favor of chemo. It's great that you have a team to meet with tomorrow.

(By the way, since we don't have a reply function that links to a specific post, if you like you can just talk to everyone in the same post, like a group conversation.)

2011 Stage I ILC 1.5cm grade1 ITCs sn Lumpectomy,radiation,tamoxifen. 2014 Stage IV ILC mets breast,liver. TaxolNEAD. Ibrance+letrozole 2yrs. Fas+afinitor nope. XelodaNEAD 2yrs. Eribulin,Doxil nope. SUMMIT FaslodexHerceptinNeratinib for Her2mut NEAD
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Jun 25, 2021 06:42AM Calvin71 wrote:

Thank you everyone I’ll let you know what they say .

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Jun 25, 2021 09:10AM - edited Jun 25, 2021 09:12AM by LIgma

Hi Calvin,

First time chiming in on the boards but maybe my story will help. Diagnosed 01/20 with TNBC. 1.1 cm total mass (5mm of DCIS and 6mm of IDC). No lymph nodes and no lvi. Was told only the IDC gets consideration for treatment. There was never a question about having chemo. I go Msk and was told from the get go I was having chemo. Had CMF due to the fact I already have some neuropathy in my feet and MO did not want to leave me in a bad way (his words). The Taxines could make it worse. I do not regret it one bit. Good luck today. Hope this helped.

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Jun 25, 2021 09:56AM Calvin71 wrote:

Thank you . I went to Sloan in 2000. I had Cmf then . Hoping I’m able to get it again since it’s the other breast . Just sent message to my oncologist from back then for her input .

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Jun 25, 2021 02:39PM 2019whatayear wrote:

Calvin71 had you had genetic testing done? TNBC in your 30s and then back in the other breast in your 50s could mean a potential genetic mutation. Hope you have/had a good appt. Sorry you are dealing w/BC again

5/6/2019 IDC 2cm, micromet 1/9 nodes, BRCA2+, ER+, PR+, HER- BMX 6/2019, A/C & Taxol 2019, Radiation, BSO - preventative 2/2020, Letrozole 3/1/2020, Started Lynparza for 1 year preventative on 7/18/2021
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Jul 19, 2021 03:09PM Calvin71 wrote:

yes waiting on results any day but I was negative for Brac 1 and 2 in 2002

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Jul 19, 2021 04:12PM ARmom4 wrote:

I only had 3mm invasive and I had chemo. After consulting with Mayo clinic my MO recommended it. I was triple positive though.

Diagnosed age 35. ATM gene mutation.Severe reaction to Taxol and Taxotere. Just Tamoxifen now Dx 1/3/2020, DCIS/IDC, Right, 2cm, Stage IA, Grade 3, 0/2 nodes, ER+/PR+, HER2+ (DUAL) Surgery 2/10/2020 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left Targeted Therapy 3/26/2020 Herceptin (trastuzumab) Chemotherapy 3/26/2020 Taxol (paclitaxel) Chemotherapy 4/16/2020 Taxotere (docetaxel) Hormonal Therapy 5/28/2020 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 6/30/2020 Prophylactic ovary removal Surgery 3/2/2021 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 6/7/2021 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jul 21, 2021 11:39AM Calvin71 wrote:

I’m Brac 1 positive. Found out yesterday. My tumor was 1.3cm and clear nodes and margins . Chemo soon and who knows what else . I have 3 top doctors I’m consulting with but will of course probably go with my Sloan Kettering one as she has access and knowledge to the best treatments and most up to date . She has also 40 years there .

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Jul 21, 2021 12:06PM TurboKitten88 wrote:

If it were me i would want it! I wanted to throw the whole kitchen sink at it. Mine was larger also so there was never a discussion. But if needed i would say get a second opinion!<3

Dx 8/11/2017, IDC, Right, 2cm, Stage IIA, Grade 3, ER-/PR-, HER2- Chemotherapy 9/14/2017 AC + T (Taxol) Surgery 1/25/2018 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy 2/25/2018 Whole-breast: Breast
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Jul 24, 2021 10:09PM - edited Jul 24, 2021 10:09PM by ShetlandPony

It is really good that you got the more current BRCA testing, as your positive results can influence treatment. Well done seeking second opinions including MSKCC. Everything taken together (and I see the tumor size was upgraded), it makes sense to do chemo. Go for it, Calvin! Take your opportunity to blast this cancer. Wishing you well.

2011 Stage I ILC 1.5cm grade1 ITCs sn Lumpectomy,radiation,tamoxifen. 2014 Stage IV ILC mets breast,liver. TaxolNEAD. Ibrance+letrozole 2yrs. Fas+afinitor nope. XelodaNEAD 2yrs. Eribulin,Doxil nope. SUMMIT FaslodexHerceptinNeratinib for Her2mut NEAD

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