Triple Negative

Triple negative means the tumor is ER- (estrogen receptor negative), PR- (progesterone receptor negative) and HER2- (HER2/neu negative). If you're ER- and PR-, you can't be treated with tamoxifen (for premenopausal women) nor aromatase inhibitors (for post-menopausal women), two types of hormonal therapy. If you're HER2-, you can't be treated with Herceptin, a biological therapy. Triple negative cancers are very aggressive and typically found in younger women.

Triple negative also means you could have the BRCA1 gene mutation. I need to follow up on this.

Pleural effusion

A pleural effusion is an abnormal collection of fluid between the thin layers of tissue (pleura) lining the lung and the wall of the chest cavity. Malignant pleural effusions are very, very bad. Ma's PE showed up in her x-ray and PET scan. 600ml was drained from her lung. I don't know if it means anything, but the affected lung is contralateral (on the opposite side of the body) to her tumor. She also was asymptomatic. She felt no difference after the fluid was drained.

Tumor Board

I mentioned tumor board in my first post. Basically, a bunch of doctors get together and review a case. The doctors may include medical oncologists (chemo doctors), radiation oncologists, and surgeons. When we got our second opinion from Stanford, Dr. G consulted with other breast cancer oncologists in the office; it wasn't a formal tumor board. Stanford does have a more formal tumor board where patients can request that their cases be reviewed, but they have to pay for it. At Doctor's Medical Center in San Pablo where Ma is being treated, they have a tumor board every week. Her case will be presented next Wednesday, May 21. There is no fee for this.