Triple negative node positive

Hi there. I was diagnosed in January 2024 which was originally staged as stage 1 grade 3 with 2 small tumours. My pathology results were not what we expeccted and my sentinel node contained 8mm macromet. They want to go back and do an Auxillary nodr clearance. I now think i shoukd get chemo knowing it is in my nodes. I got a CT scan and other than one lung nodule which they cant say is anything sinister, they have said there is no evidence of metatastic disease in my body. I got the impression was they wanted to do the clearance as they could get me in quicker for that. I just worry if i do the clearance, they may find a lot more and then chemo treatment is delayed whilst i recover. My mind doesnt know what to do. The oncologist has said his preference would by clearnace first but equally he would be happy for me to do the chemo first. I still await results of BRCA results which may mean i have to have further surgery anyway. Do people usually have chemo first? My anxiety is going through the roof. I have 3 children and fear my life is over.

Hi, I’m triple neg too.
My tumour was small, 16mm with negative nodes.
I felt hard done by that I wasn’t offered chemo first and that I don’t qualify for pembromizalab.
However I was able to speak with a really helpful oncology pharmacist who explained that I basically wasn’t bad enough to need pembro and neo adjuvant chemotherapy.
Have a look at the PREDICT tool, and remember that by far the biggest improvement in outcomes in BC is by the surgery, not the chemo and radiotherapy.
My outcome is 72% from surgery and only an additional 6% from chemo and radiotherapy combined.
I also believe that if your offered neoadjuvant chemo to allow you the possibility of breast conservation surgery don’t dismiss it.
I think often in the extreme anxiety of early diagnosis women say take my breasts I don’t care, just get it out and in the future may well regret that decision.
All triple neg breast cancer ladies will have chemo before or after surgery and all breast conservation ladies will be offered radiotherapy, as a mop up, belt and braces approach xx

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Thank you for replying. I really appreciate it.

So i was originally node negative at ultrasound but aftet lumpectomy i am now node positive so i really didnt understand why they werent then offering chemo because if i was node positive from the start i would have gone straight to chemo.

What I have learnt is that what is diagnosed pre op often changes post op.
That’s nobody’s fault, just the limitations of the biopsies etc.
I think we also put a lot of significance on the cancer travelling via the lymph and sometimes forget it can also travel via the blood stream.
I sort of feel reassured that I’m having chemotherapy (even though I feel like crap). My understanding is that at all triple neg women would be offered it x

Thank you so much for replying again.

Yes i will definitely be offered chemo but after surgery and my recovery period but my oncologist has now said we can do chemo first if i like. It has been left to me to decide which is so hard

Have you discussed surgical options yet. My understanding was that pre op chemo was designed to shrink the tumour to make breast conserving surgery easier and less invasive.
I know that many women’s gut reaction is mastectomy ASAP, but personally for me that was a massive deal.
I was pleased to be advised that lumpectomy had the same outcome.
It’s not easy surgery even though and it’s not pretty but for me it was a relief.
I do know that things could change if it comes back :disappointed:

I had a lumpectomy 4 weeks ago and recovery ok apart from a slight lump (i hope scar tissue) has formed. The lymph node involvement has only been discovered post op and i just want to avoid another surgery so soon. They got clear margins in breast so no need for further breast surgery…yet and lets hope thats the case.

Thank you for your replies