Unusual to only respond to one type of chemo?

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Hi, I was diagnosed with TNBC last September and have had 9 weeks of weekly Paclitaxel/ Carboplatin followed by 3 x 3 weekly EC. The halfway MRI showed a reduction in the tumour from 34x27mm to 22x10mm and I could feel a reduction in the lump. I didn’t have another MRI following the second lot of chemotherapy prior to surgery. I have since had a lumpectomy with full axillary node clearance and they are happy they have clear margins, no lymphovascular invasion and only 1/17 lymph nodes was positive (which I knew from initial scan but had reduced from 15mm to not being measured on final scan likely because it was less than 3mm). 

I am really confused by my pathology results as it has come back that the tumour was 3cm and no response to treatment. This obviously contradicts the midway scan. I’m wondering whether it responded well to the first lot of chemo but not to the second which I’ve been told could be possible but would be unusual. I’m just wondering how common this is as I’m aware of some other women who have experienced similar and whether it has any significance / meaning in terms of likelihood of recurrence / spread?

Thankyou 

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Hi RABS17 

Thank you for posting your question. 

It is understandable that you feel worried about the difference in measurements between your scan and final pathology report. 

It is possible, as you say, for a tumour to respond differently to different treatments. This is because different chemotherapy drugs affect the cancer cells in different ways, which is why a combination of chemotherapy drugs is used to get the best possible effect.  

It is also important to remember that while scans can give a good idea of the size and shape of a tumour, they are never as accurate as looking at the tissue under the microscope and it is not uncommon for the size to be different on the final pathology report.  

Your treatment team or breast care nurse would be best placed to answer your question about your risk of recurrence. The treatment team look at all of the features of the cancer to help decide if any further treatments would be helpful for you to reduce the risk of the cancer coming back in the future. You can call your breast care nurse to discuss this, and ask any questions that you have.  

We offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which you may be interested in.  They include face to face and online courses and events. For more details about all of these services, please see the information on the link. Our Someone Like Me service can also put you in touch with a trained volunteer who has been through a similar experience to talk to.  

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Best wishes 

Cassie 

Breast Care Nurse 

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