What's the typical treatment order for stage 4 triple negative breast cancer?

Getting a stage 4 triple negative diagnosis can feel overwhelming, and it's completely natural to have questions about what comes next in terms of treatment planning. Treatment approaches for metastatic triple negative breast cancer typically focus on systemic therapy first to address the spread of cancer throughout the body, with surgery decisions made based on individual circumstances and how well the treatment is working. Each person's treatment plan is unique and depends on many factors that the medical team will discuss, so connecting with the oncology team about the specific approach and timeline will provide the clearest guidance for this particular situation.

Move quickly with getting treatment…don’t delay. I’m at Stage II, but at Grade 3, ki67 of 90%. The grade tells you how aggressive your cancer is. Grade 3 is the highest. Anything with a ki67 of 30% or greater is considered highly aggressive (fast growing). I’m 90%. Thursday will be my 8th chemotherapy, but PET scan and MRI show growth. I want a second opinion about best course of treatment. Please educate yourself and advocate for yourself.

My Ki score was 95% and rare, as TNBC, and initially I had no spread and staged 1 grade 3. I have BRCA 2. I was told most breast cancers have Ki of 20 to 30, so mine was very aggressive and they did a case study on mine, when it spread post op. My mammogram was clean but because of BRCA, I had routine breast MRIs that found the tumor at 4.7mm. I had the required double mastectomies and at the time of surgery margins and nodes were clean but my 1 small tumor was 2 in surgery. Chemo not needed. Within 9 months I spread to a node regionally and it was necrotic. I required very aggressive chemo as Carbo/taxol weekly 12 weeks, Adriamycin Cytoxan every 2 weeks as 8 doses, surgery to clean up the node area, than Xeloda 3 months, 15 hi dosed radiation, and a year of Lynparza for the BRCA defect. Now, my bone marrow is either extremely malnourished or possible leukemia from the aggressive treatments. I’m doing everything as recommended and aggressive exercise as able daily. Please do whatever they recommend as they are the experts. I am a critical care RN. You will do well. Chemo and surgery is the main tx for TNBC. With a spread I have seen chemo used first. I could not get immunotherapy due to autoimmune conditions. Everyone has a different journey depending on cell type, aggression, stage, and your health status. Best wishes and prayers. The journey is ongoing. 🙏❤️

I want to send sincere wishes for all TNB patients to do well with successful treatments and a long healthy life. I met someone with Grade 3, ki67 of 95%, who has lived a good quality of life for 16 years and counting.

Thanks Mary. Journey ongoing.

I'm triple negative stage 4 as well and in my situation when they realized it was stage 4 and not stage 3 they said surgery was no longer a option and treatment would be a lot of chemo and I did more than 10 months of chemo in a 13 month period but am currently NED