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Living with cancer· Appointment prep

Appointment sheet: Early triple-negative breast cancer

One page to bring and write on: your details, the questions for Early triple-negative breast cancer plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Early triple-negative breast cancer

Prepared with OnCo (onco.cc/prep/tnbc-early/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

20 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example Oestrogen and progesterone receptor under 1 percent and HER2 0 to 1+, or 2+ without amplification, Germline BRCA1, BRCA2 and PALB2, Tumour-infiltrating lymphocytes, Pathological complete response and residual cancer burden at surgery, PD-L1), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Stage I, tumours 2 cm or less without node involvement
  1. 5.For my situation (stage i, tumours 2 cm or less without node involvement), which of the standard options do you recommend and why?
Stage II to III, before surgery
  1. 6.For my situation (stage ii to iii, before surgery), which of the standard options do you recommend and why?
  2. 7.Am I a candidate for Pembrolizumab, Carboplatin, Paclitaxel / nab-paclitaxel or related drugs, and what side effects should I expect?
  3. 8.How do the results of KEYNOTE-522 apply to someone like me?
After surgery, pathological complete response
  1. 9.For my situation (after surgery, pathological complete response), which of the standard options do you recommend and why?
  2. 10.Am I a candidate for Pembrolizumab, and what side effects should I expect?
  3. 11.How do the results of OptimICE-pCR (A012103) apply to someone like me?
After surgery, residual disease
  1. 12.For my situation (after surgery, residual disease), which of the standard options do you recommend and why?
  2. 13.Am I a candidate for Pembrolizumab, Olaparib, Capecitabine, and what side effects should I expect?
  3. 14.How do the results of OlympiA and ASCENT-05 / OptimICE-RD (AFT-65, GBG 119, NSABP B-63) apply to someone like me?
Local therapy
  1. 15.For my situation (local therapy), which of the standard options do you recommend and why?
Any stage
  1. 16.Are there clinical trials I could join, for example of ASCENT-05 / OptimICE-RD (AFT-65, GBG 119, NSABP B-63), OptimICE-pCR (A012103), SCARLET (SWOG S2212), MRD / molecular residual disease testing?
  2. 17.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 18.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 19.I read that “No trial has tested capecitabine or olaparib on top of adjuvant pembrolizumab for residual disease”. How does that affect my plan?
  5. 20.I read that “About a third of patients do not reach a complete response and most relapses come from them”. How does that affect my plan?

The words I may hear

  • Tumour-infiltrating lymphocytes (TILs): Immune cells that have got inside the tumour.
  • Residual cancer burden (RCB): A pathology score for how much cancer remains in the breast and lymph nodes after pre-surgery treatment, from 0 (none) to III (a large amount), combining tumour bed size, cellularity and nodal involvement.
  • Pathologic complete response (pCR): No invasive cancer left in the breast and lymph nodes when the surgeon removes the tissue after pre-surgery treatment.
  • Lumpectomy (breast-conserving surgery): Removing only the tumour with a rim of normal breast, keeping the breast; almost always followed by radiotherapy.
  • Mastectomy: Removing the whole breast, either for cancer or preventively in BRCA1/2 carriers, where bilateral risk-reducing mastectomy cuts breast cancer risk by 90% or more.

Tests and results to bring

Biomarker results to ask for: Oestrogen and progesterone receptor under 1 percent and HER2 0 to 1+, or 2+ without amplification, Germline BRCA1, BRCA2 and PALB2 (olaparib eligibility, surgical choices), Tumour-infiltrating lymphocytes (prognostic, de-escalation trials), Pathological complete response and residual cancer burden at surgery, PD-L1 (not required for pembrolizumab in early disease), Circulating tumour DNA after surgery (investigational).

Scans and tests linked to this cancer: Germline (hereditary) testing, MRD / molecular residual disease testing.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call