RCB 3
I had a mastectomy on my left breast two weeks ago and received my final pathology report last week. My RCB is 3.387. I feel depressed.
Last October, I was diagnosed with ER+(90%)/PR+(60%)/HER2- (++) breast cancer with a Ki-67 of 90%, multiple tumor sites, and one positive lymph node. Because my Ki-67 was so high, my oncologist believed I would benefit from chemotherapy. I completed four rounds of AC, and ultrasound showed a significant reduction in size. I then completed four rounds of Abraxane; the subsequent MRI showed results similar to the ultrasound.
During surgery, the surgeon removed three sentinel lymph nodes. The one that was positive before chemo remained positive; the other two were negative. The surgeon then removed eight additional axillary lymph nodes, all of which were negative.
The pathology report stated that therapy-associated changes were not identified in the lymph nodes. For the tumor sites, the largest single focus of residual invasive carcinoma measures 1.8 cm. The overall residual tumor cellularity (invasive carcinoma and DCIS) is approximately 80%, of which 50% is DCIS. My calculated RCB score is 3.384.
I saw my oncologist today. She essentially said the chemo didn’t do much, though she followed current guidelines by administering it first. She also mentioned that she and many other oncologists believe ++- patients should not necessarily start with chemo.
I am overwhelmed by negative thoughts. I knew I might not achieve a pCR, but an RCB-III feels devastating. I am moving forward with radiation and hormone therapy, but I am terrified the cancer will return. I am 40 years old with three children, including a 20-month-old baby girl. I want to see them grow up, and I don’t know how to process this.