Chemo before or after surgery?

BellydancerinNJ

Hi, I'm 28 and newly diagnosed.  My doctors are recommending chemo first to shrink the tumor (4cm) then do surgery.  Lumpectomy if it's gotten small enough.  I haven't had the BRCA test yet, so I guess that will help to influence my mastectomy decision.  Well-meaning people keep giving advice and some are saying to do chemo after surgery.  I'm just wondering what others have done.  I'm hoping to get to a fertility specialist to preserve eggs, since I'm single and never had kids but want them one day.  I hope to use this forum to sound off and learn from other real patients.  Thanks!

lexislove

 Hi there...

Sorry you had to join us at a young age too, I was diagnosed at 30. this site is wonderful and full of woman who know their "stuff".

Chemo before surgery is used to shrink larger tumors so they can easily be removed at surgery time or so you can have a lumpectomy.

It is becoming more common to do this method with larger tumors.SO this is not unnormal.

A pro to doing this is that you and your docs can see if your chemo is working.

I myself had neo adjuvant chemo before sugery and in retrospect I'm glad I did. I didn't really have a choice though. I myself chose a mastectomy, but everyone is different. The BRCA test will help deffinatly with your decisions.

Come here to ask questions and get support!

There have been many threads on neo adjuvant chemo (chemo b4 surgery) you can search for them!

BellydancerinNJ

Thanks so much, I did find one that was full of useful info.  I'll definitely take some time to check the other threads. Thanks for your response, I have a feeling I'll be spending a lot of time on here!

lexislove

Belly...your docs are on the right track..listen to them

Deb-from-Ohio

Belly I had neoadjuvant, 4 A/C and then Taxol, I just did # 10 of 12 weekly today...my oncologist can no longer even find the lump in my breast or under my arm...so I love it...Can go ahead with my planned lumpectomy! And they won't have to take as much this way.

Good Luck

Deb

brst26

Sorry that you have to do this crap at a young age also!  I was 26 when I was diagnosed in July of 2007.  I did chemo first to shrink my tumor...and I highly recommend it!  Even if you decide to have a mastectomy, depending on where your tumor is located could determine to what extend of surrounding tissue may need to be taken.  I opted to have a lumpectomy plus radiation (which by the way has the same prognosis rates as mastectomy) due to my age.  I am BRCA 1+...but still did not feel the need to have a mastectomy or bilateral mastectomy.  Each person has to make the decision that is right for her though.  I wish you the best of luck in all of your treatment!  Please feel free to ask any questions that you have....the women on this board are amazing!  They helped me get through treatment.

BellydancerinNJ

Thanks for the info, I hope everything is going well for you!  I'm hoping to do the same thing:  chemo to shrink, then a lumpectomy.  We'll see how treatment goes.  I still have a couple of more tests to take but hopefully can start chemo soon enough.

jenns

Belly,

 I had the exact same question myself in mid January.  My local breast center in CT was advising chemo before surgery.  My lump was at least 4 cm and I had micro calcifications as well and postive lymph nodes.  I too was waiting for the gene test which takes about 3 weeks to get results. then I went to Sloane Kettering and they suggested surgery first.  I felt like I wanted the cancer out of me as fast as possible.  I also didn't want to wait and see if the chemo was going to shrink it what if I do chemo and it doesn't shrink?  My tumor was very aggressive so I decided to go with Sloan's suggestion.  I just wanted to share my experience as well.  You can go either way. I had a dble mastectomy at the end of January and now I am now into my chemo treatment and doing okay.  Good luck to you and I love the fact that you are a belly dancer!!

You go girl 

lovinmomma

I have done the chemo first. the reasoning I had was that way they would know if the chemo was actually working.  I did 4 rounds of AC and 4 rounds of Taxotere.  The AC shrunk my tumors to almost nothing. So I know that it worked on my lumps. 

lissette80901

 hi bellydancer.  I am from NJ too but live in California now.  I am 32 recently diagnosed and have to make the same decisions as you did.  I noticed you were diagnosed in october and am wondering what you decided to do.  I am meeting with a fertility specialist as well.  Were you able to harvest your eggs?  Did you do the chemo or surgery?  It would be great to know what you decided and how you feel about it.  These are tough decisions to make.

BellydancerinNJ

Thanks for sharing everyone. 

Lisette, I was originally planning on doing chemo first, as my surgeon recommended, but since the whole egg freezing issue has come up I might do surgery first.  Reason being I'd have to wait 5-6 weeks until we can harvest eggs, and my docs don't want to wait that long to start chemo.  If surgery (mastectomy) is done first that gives me more time to do the egg freezing process.  Then I'd do chemo after surgery.  I see my onc on Wednesday so I'm hoping to have decisions made by then, but I'll keep you posted. I'll also find out then my HER2 and hormone results then.

Jenns, I'm feeling the same way.  This tumor hurts everyday and has grown since I was diagnosed nearly a month ago.  I just want it out too!

Verebey

Hi Bellydancer! I live in NJ too! I was diagnosed in October 2008 and went right over to Sloan. My tumor was small so they did surgery 2 weeks after my first visit. I had a lumpectomy and then 2 weeks later another small sx to clear the margins. I, also, just wanted the cancer out! I just finished chemo and am starting radiation on this Friday for 6 weeks. I have a friend in my town that was dx a few months before me and she had the chemo first to shrink, then chemo, and now just had a partial mastectomy. Every situation is different and each doctor has their own way. If you trust in your doctor and yourself than it is the right choice. Good Luck!

carol1949

Hi Bellydancer.  As the others... I am so sorry to hear of any of the young people who are fighting this beast.  I had a very large tumor and had the chemo first and it also eradicated the positive lymph nodes that were indicated by biopsy.  So, I do think it is wise to do the chemo first and go after any stray cells floating around.  Remember, we have tests that show tumors... but there are NO tests that show cancer cells!

I also highly recommend for you to get the book Dr. Patrick Quillin's Beating Cancer With Nutrition.  It gives valuable advice regarding supplements and diet that can enhance chemo while negating some of the bad side effects

Keep positive and do your research and most importantly... Listen to your heart!

Deb-from-Ohio

I too had neoadjuvant....I seen my doctor yesterday who examined me and told me I was in remission...I still have one more weekly Taxol to go after 11 of them already and have had 4 every other week treatments of A/C. Still have to have the surgery and radiation of course. I'm not sure how he can know just by feeling, I won't be satisfied until I get my cat scan here in the next week or so to see it in print. I also have an appt with my breast surgeon, April 6th,  and am sure she is going to order another MRI.

As for nutrition during chemo, I had alot of trouble keeping my counts high, so I started eating alot of protein, steaks, eggs everyday (my poor cholesterol count), anything with protein in it and wow last two chemos, no shots of lukine......wonderful. And the best advice I can give anyone going thru chemo is drink water till you can't drink anymore, it flushes it out of your system faster and saves you from dehydration which you are very prone to at that time.

Good luck!

Deb

BellydancerinNJ

Thanks for the input everyone.  I saw my oncologist today and we're going ahead with chemo first.  I'll be starting my treatments next Friday (3/27).  By then I should know my ER/PR and HER2 status, but the plan is 4 every other week treatments of A/C, then 4 of T.  Then surgery and radiation.  I wish everyone all the luck you've been giving me!