The Finishing Touches

We had the appointment with the Medical Oncologist (Dr. Zaiden) yesterday. He informed us that the particular cancer that my mom has is called Triple Negative Breast Cancer (TNBC).

Most breast cancers (about 80-85%) are fed by either estrogen, progesterone, or the protein HER2. TNBC is not fed by any of these thins. More than likely it is caused by the BRCA-1 gene being mutated, which means that it is more than likely inherited. This makes it a harder cancer to treat because there are fewer treatments options.

As far as we know, it has not metastasized out into the body, although it is in the lymph nodes. We are waiting to hear back from the oncology office with an appointment for an abdominal CT scan to check for metastasis. We are also waiting for an appointment for an ultrasound of the heart to check for structural defects and the overall health of the heart, since the chemo can potentially caused weaken heart muscles. She is going today to have a ton of blood work done to check her liver and kidney functions, since the chemo is filtered through the kidneys and cleared by the liver.

Once all of this is done, she will start on the chemo. The regimen that she will be put on is called TAC (taxotere, adriamycin, and cytoxan).

The taxotere slows or stops the cell division, or keeps enzymes from making the proteins the cells need in order to grow. The adriamycin both blocks DNA production in the cells, and also inhibits the enzymes responsible for repairing DNA. The cytoxan stops cancer cells from replicating.

She will need to be closely monitored, more so than a "normal" chemo patient, due to her being on Coumadin and the clotting factor that she has. Chemo lowers platelets, making you more prone to bleeding (which the Coumadin does as well), lowers white blood cells, making you more prone to infection, and lowers red blood cells which makes you more prone to anemia.

All of that combined with the fact that she can not have IVs in her right arm due to the reconstruction surgery that she had a few years ago and the fact that her veins in her left arm are really bad, she will more than likely end up with a port-a-cath inserted under the skin just below her collarbone.

After chemo is done, which she will get once every 3 weeks for 6 cycles, she will have surgery and then radiation for 6.5 weeks.

There is an 80% chance that after 2 or 3 cycles of chemo that the tumor will disappear completely. This won't mean that she can avoid surgery and radiation though. it will all still be done since all it takes for the cancer to come back is one single cell left behind.

The chance of recurrence and distant metastasis is higher with this type of cancer, so everything will be done to prevent that as much as possible. This cancer is also pretty rare in older white women, mainly being diagnosed in African American women in their 30s and 40s.