Small triple negative - no neo-adjuvant chemo?

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Hi, I was recently diagnosed with a 9mm grade 3 invasive ductal carcinoma as an incidental finding.

Still awaiting some investigations but it looks like it is T1 N0 M0 at the moment.

i have been told that I will be listed for lumpectomy without any chemo prior to this and will only see an oncologist after the surgery and that I “may not” need chemo but will get radiotherapy.

wondering if anyone else has had this experience? 

  • Hi  

    My TNBC was grade 3 and also very small and only found when I was recalled for an area of DCIS. I was also initially staged at T1N0M0.

    Like you, I was told that probably only a lumpectomy and radiotherapy was needed. Unfortunately, when the lumpectomy and sentinel lymph node biopsy were done, it was found that there was a tiny amount of cancer cells in one of the lymph nodes. I was then offered chemo, which I took.

    Hopefully you won't have any cells in the lymph nodes and won't need chemo.

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  • Hello Nina

    I had a mastectomy for triple negative Grade 3 tumour in 2022.  I had 4 lymph nodes removed, 3 of which were "cancer connected". I wasn't offered chemotherapy (possibly because I was 82 at the time !) but had 15 rounds of radiotherapy.  I would take the advice of the oncologist when it comes - they do know best.  So far I am fine and I am sure you will be too.

  • Thank you for replying. My tumour is very little so they have suggested lumpectomy and radiotherapy in the first instance and I can consider other options later after getting it out of me ASAP, which makes sense. I just understand it's very unusual not to be offered chemo. I'm 42 so as you can imagine I am feeling like "throw everything and the kitchen sink at this thing" because I don't want it coming back.

  • Thank you for replying. While I'm very happy if it is possible to skip Neo-adjuvant chemo as it makes the whole process a lot faster, I'm very nervous at the thought of not having any at all. Much as I hate the thought of it, I'm 42 and hate the thought of recurrence more. 

  • It's normal to feel that you need to have every possible treatment to try and prevent the cancer returning.

    Your consultant is part of a multi disciplinary team (MDT) and between them they look at your results and then follow NICE guidelines for your treatment.

    If the NICE guidelines don't recommend chemotherapy then you won't need to have it. In my case, if there hadn't been a deposit of cancer cells in my lymph node then I wouldn't have 'qualified' for chemo.

    I notice in your reply to Louka that you said

    just understand it's very unusual not to be offered chemo

    but that isn't the case. Any treatment is offered purely on the individual's circumstances and after following the clinical guidelines.

    I hope that helps put your mind at rest on why you currently haven't been offered chemotherapy.

    x

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