Treatment for TNBC recurrence as a chest nodule

[pranati_majee]

Hello everyone,

My mother on march2018 got lumpectomy then mastectomy for breast tumor, it was T4n0m0 triple negative breast cancer.in lumpectomy report LVI not present, mastectomy report LVI present and closed margin .Further treatment she got from MTMH Jamshedpur ,6cycles of EC chemotherapy and 15 days radiation. Since surgery she was asking doctor about a hard nodule on her chest but doctor told it's a scar tissue. After 1year completion of treatment PET scan show SUV of that nodule 17.doctor asked for excisional biopsy and it came tnbc with loss of androgen receptor.Now doctor told for 6weeks of radiation on chest wall.They didn't tell anything about chemo till now.what could be correct treatment plan of my mother. I need suggestions pls, what is her chances of survival.Pls give me suggestions if any body have idea of tnbc recurrence. I am not sure but I think it's a local recurrence.

[made2b2gether]

Dear Pranati,

Sorry to hear about your mother. As per your description, the initial chemo for your mother was not comprehensive. The EC (or FEC or AC) Chemo should have been accompanied by a Taxane (Taxol or Docetaxel or paclitaxel) before the EC Chemo was given. Only Six cycles of EC is not considered to be standard of care for tnbc.

Now if the recurrence to the chest nodule qualifies as metastatic or mtnbc, then you can ask a leading cancer center in India if you mother can do PDL1 or PD1 testing and qualify for Paclitaxel with Atezolizumab (Tecentriq®)) chemo with immunotherapy. This has been approved for PD1/PDL1 positive expression tumors in metastatic tnbc.

I did not understand what you say about loss of Androgen Receptor, but if you mothers cancer is showing Androgen Receptor expression, then you should also request your hospital if she qualifies for targeted therapy with a drug that can target the Androgen Receptor along with what the hospital sees as the best next treatment.

You should also ask your treating hospital why they did not offer a taxane prior to treatment with an anthracycline (the EC). This is not standard and it is not complete treatment as per guidelines.

You need to go to a bigger Cancer Center in in Mumbai or in Kolkata (TATA Memorial) to get a 2nd Opinion from a breast cancer specialist who will prescribe the next line of treatment based on your mothers tumor profile. You should also mention about the Androgen Receptor and about all scans and treatments received so far (Get a letter on all treatment received at MTMH Jamshedpur with a CD of all your scans) to take to the hospital providing the 2nd Opinion (first get an appointment).

cancertherapyadvisor.com/ho...

Wishing you mother healing and good health. Take care and follow up with Tata Memorial on next steps.

[pranati_majee in reply to made2b2gether]

Thank you for your reply.doctor who recommended ec chemo retired, here nobody want to explain what they are doing with patients. They removed only the chest wall nodule, so I think it's local recurrence. I am helpless. If we move another hospital treatment will be delayed

[made2b2gether in reply to pranati_majee]

You need to go to TATA memorial or a manor Cancer Center in India to at least get a 2nd Opinion (of course, if you can and your mothers health allows). It is just as important to get correct treatment, not just to get treatment.)

Maybe you can get a 2nd opinion at another big hospital in Jamshedpur but better would be at a larger center..ask them what is standard protocol based on the current diagnosis..and what are latest options based on her tumor profile.. take care

tigerlilyfoundation.org/wp-...

[Pankyforhelp]

Dear Pragati , Sorry to hear about your mother, I have seen pain which patient experience.

My mother is also breast cancer patient.

I would suggest you to consult with some good practitioners like Tata Hospital (Mumbai-Parel). They really have amazing expertise.

I know its far for you to travel such long distance.

But better to take chance. No need to acompany your mother for second opinion at Tata Hospital . You need to carry her all reports from Day 1 till today.

[sumeet_shah Administrator]

Don’t worry, We can understand your situation. Isolated local recurrences are curable. Time is not an issue here. If you lose a few days, won’t matter. Sometimes, some docs are good at treatment but they don’t speak much. Just discuss with your doc what exactly is the plan. If need be, take a second opinion. Tata Memorial Hospital has a second opinion online option. You can look into that. You mother will be fine soon.

[pranati_majee in reply to sumeet_shah]

Thank you sir for your reply. I will try for second opinion online option.Thank you

[pranati_majee in reply to sumeet_shah]

Thank you Dr.sumeet,thank you for all your positive words. That filled me with positivity, which is reflecting on my mother's thought.Google spread only negativity about triple negative. Thank you sir again

[MsLockYourPosts TeamBCI in reply to pranati_majee]

You are right about Dr. Google for almost all health issues!