For context, my original tumor was 4 cms with indeterminate lymph nodes status. Had sentinal node biopsy with 3 nodes removed + mastectomy. All clear and achieved PCR. So now I’m wondering what’s the latest standard for radiation. I’m meeting the doctor in next 2 days, so want to gather information on what this group or people with similar context thinks here.
Any information is greatly appreciated.
For context, my original tumor was 4 cms with indeterminate lymph nodes status. Had sentinal node biopsy with 3 nodes removed + mastectomy. All clear and achieved PCR. So now I’m wondering what’s the latest standard for radiation. I’m meeting the doctor in next 2 days, so want to gather information on what this group or people with similar context thinks here.
Any information is greatly appreciated.
I’m just wondering how common it is for PCR scenarios to get clean scans before surgery.
For me, ultrasound didn’t find anything while tumor size at diagnosis is 4.5 cms.
But PET showed mild activity of suvmax 2.8 (original 19) and mammogram showed ill defined pattern of 2 cms.
I’m wondering if pcr is still on the table and interested to know from people who achieved PCR
That’s the question basically.
Initial tumor size 4 cms, no node involved.
Ki index of 60%.
Completed 12 taxol + carbo weekly cycles
4 AC cycles
Keytruda for every 3 weeks
Did ultrasound and PET before surgery
Ultrasound came clean but PET showed FGD uptake suvmax 2.8 at tumor sight
Wondering if anyone in this group went through similar journey
Hi everyone — looking for similar experiences from this group.
My mother has right breast TNBC, ER-/PR-/HER2-, Ki-67 60%. Initial lump was around 4.5cm.
Baseline PET showed right breast SUVmax 18 and a small right axillary node SUVmax around 5.
She finished neoadjuvant treatment: 12 weekly Taxol, some carboplatin but stopped later due to reaction, then 4 AC + pembrolizumab. The lump became non-palpable early.
Recent ultrasound before surgery showed:
No suspicious remaining lump in right breast
Both underarm areas looked clear
No suspicious nodes
Post-treatment PET now says:
Small ill-defined area in right breast 1.1 × 1.5 cm, SUVmax 2.8
Previously active right underarm node has resolved
No new concerning activity elsewhere
Impression: significant partial response
Has anyone had a small low-SUV area after treatment but still got pCR? Could SUVmax 2.8 be scar/healing/inflammation rather than active cells?
Also discussing surgery plan — since the underarm looks clear and the node was never biopsy-confirmed, wondering if sentinel node biopsy is reasonable instead of removing many nodes upfront.
Would really appreciate any similar experiences.
Hi everyone — looking for similar experiences from this group.
My mother has right breast TNBC, ER-/PR-/HER2-, Ki-67 60%. Initial lump was around 4.5cm.
Baseline PET showed right breast SUVmax 18 and a small right axillary node SUVmax around 5.
She finished neoadjuvant treatment: 12 weekly Taxol, some carboplatin but stopped later due to reaction, then 4 AC + pembrolizumab. The lump became non-palpable early.
Recent ultrasound before surgery showed:
No suspicious remaining lump in right breast
Both underarm areas looked clear
No suspicious nodes
Post-treatment PET now says:
Small ill-defined area in right breast 1.1 × 1.5 cm, SUVmax 2.8
Previously active right underarm node has resolved
No new concerning activity elsewhere
Impression: significant partial response
Has anyone had a small low-SUV area after treatment but still got pCR? Could SUVmax 2.8 be scar/healing/inflammation rather than active cells?
Also discussing surgery plan — since the underarm looks clear and the node was never biopsy-confirmed, wondering if sentinel node biopsy is reasonable instead of removing many nodes upfront.
Would really appreciate any similar experiences.
My mom (58F, Triple-Negative Breast Cancer) just finished her full KEYNOTE-522 chemo + immunotherapy protocol (Taxol, Carboplatin, Adriamycin, Cyclophosphamide + Keytruda). Her 4.5 cm tumor is now completely non-palpable — her oncologist can’t feel anything and all her blood markers look great. Heading into surgery soon and have two concerns:
Her initial PET showed mild activity in one underarm lymph node — but it was never biopsied or confirmed as cancer. The PET was done just 7 days after her breast biopsy, so it was almost certainly post-biopsy inflammation. Her oncologist agrees.
Despite this, the surgeon wants to remove 11–12 lymph nodes (ALND) and told us the lymphedema (permanent arm swelling) risk is the same as the simpler sentinel node biopsy.
Has anyone been in a similar situation — good chemo response, unconfirmed node — and successfully pushed for sentinel biopsy first? Or had ALND and regretted it / didn’t regret it?
Surgeon wants a PET scan just 2 weeks after her last chemo. Problem: my mom gets filgrastim injections (Neukine) on Days 3–5 after each chemo cycle to protect white blood cells
At 2 weeks, those injections are only ~9 days old.
We’re pushing for 3 weeks. Has anyone had a post-chemo PET done too early and got a scary bone marrow result that turned out to be nothing?
Any experiences or advice
just trying to advocate as well as possible for her
My mom (58F, TNBC) just finished her full keynote-522 chemo + immunotherapy protocol (Taxol, Carboplatin, Adriamycin, Cyclophosphamide + Keytruda). Her 4.5 cm tumor is now completely non-palpable — her oncologist can’t feel anything and all her blood markers look great. Heading into surgery soon and have two concerns:
Her initial PET showed mild activity in one underarm lymph node — but it was never biopsied or confirmed as cancer. The PET was done just 7 days after her breast biopsy, so it was almost certainly post-biopsy inflammation. Her oncologist agrees.
Despite this, the surgeon wants to remove 11–12 lymph nodes (ALND) and told us the lymphedema (permanent arm swelling) risk is the same as the simpler sentinel node biopsy.
Has anyone been in a similar situation — good chemo response, unconfirmed node — and successfully pushed for sentinel biopsy first? Or had ALND and regretted it / didn’t regret it?
Surgeon wants a PET scan just 2 weeks after her last chemo. Problem: my mom gets filgrastim injections (Neukine) on Days 3–5 after each chemo cycle to protect white blood cells
At 2 weeks, those injections are only ~9 days old.
We’re pushing for 3 weeks. Has anyone had a post-chemo PET done too early and got a scary bone marrow result that turned out to be nothing?
Any experiences or advice
just trying to advocate as well as possible for her
Hi everyone
My mom (58F, Triple-Negative Breast Cancer) just finished her full KEYNOTE-522 chemo + immunotherapy protocol (Taxol, Carboplatin, Adriamycin, Cyclophosphamide + Keytruda). Her 4.5 cm tumor is now completely non-palpable — her oncologist can’t feel anything and all her blood markers look great. Heading into surgery soon and have two concerns:
1. Sentinel Node Biopsy vs Full Lymph Node Removal (ALND)
Her initial PET showed mild activity in one underarm lymph node — but it was never biopsied or confirmed as cancer. The PET was done just 7 days after her breast biopsy, so it was almost certainly post-biopsy inflammation. Her oncologist agrees.
Despite this, the surgeon wants to remove 11–12 lymph nodes (ALND) and told us the lymphedema (permanent arm swelling) risk is the same as the simpler sentinel node biopsy.
Has anyone been in a similar situation — good chemo response, unconfirmed node — and successfully pushed for sentinel biopsy first? Or had ALND and regretted it / didn’t regret it?
2. PET Scan Timing After Chemo
Surgeon wants a PET scan just 2 weeks after her last chemo. Problem: my mom gets filgrastim injections (Neukine) on Days 3–5 after each chemo cycle to protect white blood cells
At 2 weeks, those injections are only ~9 days old.
We’re pushing for 3 weeks. Has anyone had a post-chemo PET done too early and got a scary bone marrow result that turned out to be nothing?
Any experiences or advice
just trying to advocate as well as possible for her 💙