Know Your Options
- Triple-negative breast cancer is an aggressive form of the disease but it often responds well to chemotherapy.
- It is important to discuss the use of neoadjuvant therapy (chemotherapy before surgery) with your doctor, as it may be able to shrink the tumor prior to having surgery.
- Adjuvant (chemotherapy after surgery) may or may not be needed after surgery.
- Some patients who receive chemotherapy before surgery may also need additional chemotherapy after surgery.
The good thing about triple-negative breast cancer is that it often responds really well to chemotherapy. Early stage of this disease can be stages 1, 2, or 3, and this means that it is confined to the breast and/or lymph nodes that are located right under the arm. “Our primary line of attack is chemotherapy, and this is regardless of the cancer stage,” says Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Institute in New York.
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“If women have a lymph node involved or the tumor is very large, we will very often do chemotherapy upfront,” says Dr. Comen. “It is very important to know about this strategy for two reasons.”
The first is that having neoadjuvant chemotherapy may be able to shrink the tumor and make it easier to operate, and the second reason is that it can also tell the doctor whether you will need additional treatment after you have surgery. Some patients with triple-negative breast cancer may also need radiation after surgery.
“And what I mean by that, is if you have had chemotherapy before surgery, the pathologist will look at the tumor that is removed,” says Dr. Comen. “What we may find is that the tumor is gone. There will be a tumor bed, but the cancer itself is gone and that is what is called a pathologic complete response.”
But if you didn’t achieve a complete response, in addition to radiation, you may benefit from additional chemotherapy after surgery. The drug that is generally prescribed is called Xeloda; it is a chemotherapy medicine that is taken orally. “It’s very well tolerated and usually doesn’t involve hair loss and it can improve outcomes for women who still need treatment after surgery,” says Dr. Comen.