Can a woman with TNBC and kidney issues undergo chemo?

Question

Hello doctor,

I am a 51-year-old woman with a recent diagnosis of triple-negative breast cancer. My tumor is 3.2 cm in size, located in the upper outer quadrant of my left breast, and is grade 3 with a Ki-67 index of 80 %. My genetic testing revealed a BRCA1 mutation, and my oncologist recommended neoadjuvant chemotherapy before surgery. However, I have a history of chronic kidney disease with an eGFR of 52 mL/min/1.73m², and my oncologist is concerned about how my kidneys will tolerate the chemotherapy.

My latest complete blood count showed normal white blood cell and platelet counts, but borderline low hemoglobin at 11.2 g/dL. I also have mild neuropathy from a previous condition, which makes me anxious about the potential side effects of chemotherapy.

Could you provide guidance on whether dose adjustments or alternative treatments would be more appropriate given my unique medical history?

Please help.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Triple-negative breast cancer (TNBC), especially with a BRCA1 mutation, chemotherapy treatment aims to shrink the tumor before surgery and improve long-term outcomes. Chemotherapy drugs can be tough on the kidneys, and with your eGFR at 52 mL/min/1.73m², careful consideration is needed. Your oncologist may suggest dose adjustments or use fewer nephrotoxic chemotherapy agents to minimize the impact on your kidney function.

Monitor kidney function closely during treatment. Your borderline low hemoglobin at 11.2 g/dL is something to watch as well, as chemotherapy can sometimes further reduce hemoglobin levels, leading to anemia. Close monitoring of your blood counts will be essential.

Chemotherapy agents can cause or worsen neuropathy. Again, dose adjustments by your oncologist are needed. Your oncologist will collaborate with a nephrologist to monitor your kidney function closely throughout treatment. Please feel free to follow up with any additional questions.

I hope this information will help you.

Thanks.