Hi RvW
This is where you really do need to listen to clinicians’ advice. Triple negative is very aggressive and the fact that you have your third recurrence shows how hard it is to treat. But things are constantly changing. There are new drugs for TN, for example - one, Trodelvy, with a 50% success rate.
You say you have only a 6.5% chance of preventing recurrence and I can appreciate that, third time round and soon after a second mastectomy, you’re sceptical, if not worn down. However, that 6.5% includes some for whom there is zero benefit and some for whom there’s a huge benefit and, sadly, we have no way of knowing which side we’ll be on.
If there is a greater chance of your TNBC returning or, worse, metastasising without the treatment, surely further chemo is worth the effort? I have metastatic TNBC, having had chemo in 2019 for two tumours, one hormone-receptive, the other TN. It was the TN cells that defied the chemo and I’m now on lifelong chemo with quarterly scans and 3-weekly consultations. The prognosis was not good but I have disproved the statistics and, 2 years on, I’m still on my first line chemotherapy. But it really takes its toll and, for some patients, there’s the additional psychological burden of a secondary diagnosis. I guess I’m saying that I can’t imagine anyone risking this kind of life. But that’s a personal opinion and, as you say, it will be your choice.
Just bear in mind the nature of TNBC and its capacity to reach those parts we really don’t expect (in my case, breast cancer behind my nose and in my eyelid - how’s that for unexpected!). I would prepare a long list of questions for Monday. Explain your reservations. Ask about the risks if you decline the treatment, find out if clear margins were secured during the mastectomy and if there’s any lymph node involvement - then weigh it all against going through all that hell again. But remember, the odds are that, with TN and limited treatment, you could end up like me, consigned to the joys of lifelong chemo which might (only might) have been prevented. Triple Negative is an absolute b***er!
I hope you reach a decision you can live comfortably with. All the best
Jan x