Surgery first

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Hi, I was diagnosed TNBC grade 2 , 2 small tumours in left breast in November. Considered small enough to not have chemo first. Had lumpectomy on December 19th. I'm now awaiting my histology report.

I'm petrified I won't be offered chemo !! Sounds nuts but my consultant seems so laid back, I'm scared that my treatment won't be aggressive enough to get rid of the cancer. I'm not coping well with the whole thing and the thought of having to go through this again is awful.

Does everyone with triple neg have chemo before or after surgery.

And do all lumpectomy patients have radiotherapy ?!

  • Hi  

    I was diagnosed with TNBC in April 2022. Like you, I had a lumpectomy first as my lump and DCIS were small. This was followed by chemotherapy and radiotherapy. The original plan didn't include chemotherapy but a micro met was found in one lymph node so the oncologist said I'd benefit from having chemo, which I went ahead with.

    Everyone's treatment plan is tailored to them and depends on what they find as they go along.

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  • I think it will depend on the pathology from your surgery. I think from having read several protocols that chemo is normally offered if the tumour was larger than 0.5cm, or if there is anything in the lymph nodes, or if there is vascular invasion at the tumour site. Not sure whether being grade 2 rather than grade 3 makes it less likely they will offer chemo, as most TNBC is the nastier grade 3. The surgery team won’t take the lead on this - you are likely to have a separate meeting with the oncology team after you have had the meeting to discuss your results.  All the best. 

  • Hi  

    I was diagnosed with grade 2 TNBC and was told from start that I would have to have chemo. I had the lumpectomy in July and then started the chemo in September. I have the last chemo tomorrow and then start 2 weeks of radiotherapy in Feb. 

    Once I got the results from the lumpectomy I was told the tumour was grade 3 but the plan stayed the same as no lymph node involvement. 

    Having the chemo and radiotherapy calmed me weirdly as I feel at least they’re hitting it with everything they’ve got incase it’s spread. I’m still worried a little as my head initially told me a mastectomy would reduce chance of recurrence more than a lumpectomy but the my surgeon was adamant that it was unnecessary in my case. I hope he’s right! 

    Good luck with your journey. 

  • Hi Vibby

    Sorry to hear you’ve been diagnosed with TNBC. 

    I had a lumpectomy in November and the biopsy from that showed I was triple negative so now I’m having chemotherapy. 
    My first session is tomorrow. 
    Hope you soon get your treatment plan sorted out so you can plan ahead. 

  • Hi Vibby. Welcome to the club no one wants to join. I was diagnosed with stage 3 idc tnbc in November. Originally I was told I would need chemo before surgery but after all the extra tests I just needed a lumpectomy which I had mid December. My doctor also seemed quite calm. Went back today to get all the results. Cancer was gone and there was no lymph node involvement but was told will need chemo then radio which was something I wasn’t really expecting. I think chemo is fairly standard with tnbc as it doesn’t really respond to the tablets that are available. Trust your doctor and if you don’t ask for a 2nd opinion. Try to keep positive and wishing you all the best for a good result. Take care. You can do this 

  • Thankyou x 

    Your scenario is what I imagine I will be, 2 small tumours triple neg, hopefully clear margins and negative sentinel node biopsy.

    But feel in my gut I should have chemo and radiotherapy to reduce recurrence risk.

    Less than 24 hours to go now, so will see what tomorrow brings Pray