Vein issues TNBC adjuvant chemo

Dear TAH

Thank you for getting in touch with the Macmillan Cancer Support . My name is Joanne, and I’m one of the Cancer Information Nurse Specialists. Welcome to our online community and I hope you find it helpful and supportive.

We’re sorry to hear about your diagnosis of TNBC, the treatment regimes for this type of breast cancer can be tough but you seem to have a positive mindset and have coped well with your treatment to date.

You mention that despite being triaged before treatment on 6^th January you have experienced new symptoms and pain. On the support line we can’t access medical records so we tend to err on the side of caution and advise people that if they have a symptom that persists, gets worse or, is changing then they must report it to their specialist team so they can physically assess and best manage from there. If you haven’t already reported this to your team, we would strongly advise you to do this TODAY.

Your concerns about how you would manage further treatments are valid, however there are options available to improve the access to your veins. You would need to discuss them with your team to decide which are best for you but there are devices such as PICC lines or Portacaths that can be put in place so that larger veins can be used. These veins tend to be less sensitive to chemotherapy and treatment is better tolerated.

When TNBC is treated your specialist team will want to use a combination of different treatments both to treat the cancer and to reduce the risk of the cancer returning in the future. The mastectomy has removed the cancer this is classed as a local treatment. It only treats the local area where the surgery takes place. To improve long term survival this needs to be combined with a systemic treatment; this treated any rogue cancer cells that may be elsewhere in the body and reduces the risk of the cancer you have coming back.  For TNBC the systemic treatment is chemotherapy. Completing both types for chemotherapy usually gives the best long-term prognosis so it’s important to have a thorough discussion with your specialist team before deciding not to have the Docetaxel. They will be able to give you an individualised risk/benefit assessment to help you make that decision.

All the treatment you are having is aimed at treating the cancer you have been diagnosed with and reducing the risk of it returning in the future. The risk reducing surgery you will have for the BRCA2 gene is a separate treatment plan. This is to reduce the risk of you developing a second cancer either in the breast or ovary, it will not help reduce the risk of the cancer you have returning.

Treatment plans for TNBC and BRCA2 are complex, and information is often given at a time when you are overwhelmed with emotion and information. It may be a good idea for you to have another discussion with your team, so you understand fully the rational for all the treatments you are being offered. Your specialist nurse should be able to help you with this.  I also wonder if you might benefit from giving our support line a call. We often find we can explain our answers in a bit more detail over the phone, giving you the opportunity to ask more questions if needed. It can be very overwhelming not knowing how things might affect you moving forward. And although we can’t tell you exactly what to expect, we can help explain what usually happens for most people in a similar situation.

I hope this information has been helpful and if there is anything else we can help you with please feel free to get back in touch.

Best wishes

Joanne, Cancer Information Nurse Specialist

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.

Ref/ JF/KR

Hi Joanne,

Many thanks for taking the time to provide such a thorough reply, much appreciated.

I will talk with my team in more depth.

Kind regards