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:
- 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?
- 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