TNBC IDC Grade 3: Stayed Active Post Surgery and during Chemotherapy

Malaysia, 47yo, TNBC IDC Grade 3: When you first look at Tri Juli Yety’s case, it is easy to focus on the diagnosis: triple-negative breast cancer (TNBC), invasive carcinoma of no special type (NST), Grade 3.

But when you follow her journey from the beginning, what stands out is not only the medical timeline. It is also how quickly life had changed for her, and then, gradually, how she began finding her rhythm again.

Tri Juli was 47 years old when her breast cancer journey began in March 2026.

It started with a suspicious breast lesion

On 3 March 2026, she underwent a series of investigations. A chest radiograph was normal, but an ultrasound of both breasts showed an irregular hypoechoic lesion with internal microcalcifications and vascularity in the left breast at the 11 o’clock position, measuring approximately 2.3 cm × 1.6 cm. The finding was classified as BI-RADS 5, meaning it was highly suspicious and required further investigation.

A mammogram with tomosynthesis showed a corresponding irregular lesion with clustered microcalcifications in the left breast.

Interestingly, the first trucut biopsy on 11 March showed no evidence of malignancy. However, the clinical and imaging findings were suspicious enough that the investigation continued.

Following surgery and further histopathological examination on 13 April, the picture became clear: this was invasive carcinoma, NST, Modified Bloom and Richardson Grade 3, pT2. The tumour was ER-negative, PR-negative and HER2-negative (CerbB2 1+), confirming the diagnosis of triple-negative breast cancer. A subsequent examination of the left axillary lymph nodes found no malignancy in 10 lymph nodes examined (0/10).

She had undergone breast-conserving surgery, including removal of the breast lump and lymph node dissection. Although the lymph nodes were negative, she was still facing an aggressive Grade 3 triple-negative breast cancer and was preparing for systemic chemotherapy.

When we first met her, the cancer treatment had not started yet, but recovery from surgery was not easy.

At the initial meeting on 19 May 2026, Tri Juli and her husband joined the consultation together with Dr Chandran, interventional radiology and interventional oncology and Dr Bilgin medical physicist, both from the ECCT medical team.

At that point, she was physically mobile and generally functioning well, but the surgery had taken something out of her. She described feeling weak, having a poor appetite and even feeling nauseated when she looked at food. She had little interest in solid meals, although her weight was still being maintained.

Despite this, she was trying to keep herself moving. She slept early, woke in the morning and continued going for walks. She also reported walking on the treadmill or in the gym for around 3 km, taking approximately an hour.

She had not yet started chemotherapy and was keen to explore whether ECCT could be used alongside her oncology treatment.

The early changes were not about scans yet. They were about how she felt.

Tri Juli started ECCT toward the end of May.

During the first few days, she reported experiencing body warmth after using the blanket. A few days later, she sent an unexpectedly cheerful update: she was feeling so energetic that she could not sleep that night.

Her treatment schedule was then adjusted by Dr Chandran team to gradually adjusted toward longer sessions as she became comfortable with the routine.

In early June, she temporarily paused around the time of her chemoport insertion and hospital appointments. Her staging CT scan on 8 June was important because it provided a clearer picture of where things stood before chemotherapy began.

The CT of the chest, abdomen and pelvis showed no evidence of distant metastatic disease. There was no axillary, mediastinal or abdominal lymphadenopathy, no liver lesion and no suspicious bone lesion. The scan did identify a postoperative collection near the left axilla, considered consistent with a possible postoperative seroma, as well as a thyroid nodule that was considered potentially benign. So, in simple terms, the staging scan did not show that the breast cancer had spread to distant organs.

On 15 June 2026, Tri Juli received her first cycle of chemotherapy.

The planned chemotherapy sequence was:

• Cycles 1–4: Doxorubicin + Cyclophosphamide

• Cycles 5–8: Paclitaxel

Her first chemotherapy cycle was not entirely smooth. She reported numbness and pins-and-needles sensations in her hands and feet, a slight headache, stomach discomfort and irregular breathing. The following day, however, she reported that she was already feeling better.

During this period, she continued her ECCT sessions, with her good progress, Dr Chandran then adjust to increasing to one hour, before progressing further to two-hour sessions as her treatment programme continued.

Her chemotherapy continued chronologically with:

• Cycle 1: 15 June 2026 — Doxorubicin + Cyclophosphamide

• Cycle 2: 6 July 2026 — same chemotherapy regimen

• Cycle 3: 27 July 2026 — same chemotherapy regimen

Throughout this period, ECCT was continued around her chemotherapy schedule, with rest days and treatment adjustments where necessary.

What was particularly noticeable was how her day-to-day condition began to change

By late July, her updates sounded very different from those at the beginning.

The woman who had initially described nausea when seeing food and difficulty feeling interested in solid meals was now reporting that her appetite was very good.

She said she was sleeping well. She reported no pain or swelling.

More importantly, she was active.

She was exercising daily, sometimes for one to two hours, and described feeling well supported by her oncology and ECCT team. Even when she had a busy day, she don't skip ECCT session because, in her own experience it gives her relaxation and energy, feeling like recharge right after ECCT session.

By August, she was walking for approximately two to three hours a day and reported being able to perform repeated exercises using 8 kg of weight without difficulty. She described feeling that, when chemotherapy left her tired, using the blanket helped her personally feel as though her energy had been “topped up.” She was able to progressively return to a high level of daily activity. By this point, ECCT had become more than something she was trying because of a cancer diagnosis. It had become part of her personal daily routine, something she combined with quiet time, meditation and rest.

Looking at the whole journey

Tri Juli’s story is still ongoing. She went from:

• recovering from breast surgery,

• feeling weak,

• struggling with appetite,

• feeling nauseated by the sight of food,

to later reporting:

• good appetite,

• good sleep,

• no pain or swelling,

• regular daily exercise,

• longer walking durations,

• and the ability to continue with a physically active routine while undergoing chemotherapy.

Her imaging also confirmed that the staging CT performed in June showed no evidence of distant metastases.

Alongside her conventional oncology treatment, she chose to incorporate ECCT to support her journey and being able to feel active and good thorough treatment means a lot more to her. It is a meaningful snapshot of how one patient navigated the early months of treatment, not by stopping her oncology care, but by finding a routine that she felt helped her remain engaged, active and connected to the things she wanted to continue doing.

This case describes an individual’s documented journey and is provided for educational and informational purposes only. It does not constitute medical advice and should not be used as a substitute for professional medical consultation, diagnosis, or standard-of-care treatment. Individual outcomes may vary, and this case should not be interpreted as a guarantee or indication that any particular outcome, response, improvement, or result will occur in another individual.