Any Stage III folks have chemo before & after surgery?

PlantLover

My husband and I were talking last night about the treatments I received.  

I had TCH (6 rounds) before surgery.  My tumor had shrunk prior to surgery to the point that it could not be felt via external exam.  The pathology from surgery revealed that I had micromets in 3 nodes.  Based on that my oncologist recommended 12 rounds of Navelbein after I completed 38 radiation treatments.

Of course it's all behind us now but he and I are curious if anyone else had this course of treatment, even if the chemo drugs were different.  My onc didn't make it sound like it was an unusual treatment path and I made the assumption that it was typically recommended for anyone with positive nodes after the first rounds of chemo if positive nodes were found during surgery.

Thanks!

Kay_G

I had cancer left after AC then taxotere, but no more chemo got recommended. I was still doing herceptin and now tamoxifen, and still am, but I am sure you were as well. I sure hope I had/am having enough. Nice to hear you had partial response too and are doing well two years out from dx.

PlantLover

Kay ... thanks for responding.  I sure didn't mean to make anybody start to worry if they had enough treatment.  I'm sure you did.

Hubby and I were just talking about last night when I was telling him about the Navelbein thread on this forum.  Just curious if anyone else had their onc recommend that path.

NancyD

I had four rounds of TAC before surgery and two more between surgery and rads. I thought that was pretty aggressive, but yours sounds even more! Actually, I would go with your dr's reccommendation. I think you do best if you hit it hard the first time and give it little room to get another foothold.

jennyboog

I didn't do that same tx but did do neoadj. I did ACx4, taxoterex4, BMX and had residual BC left in my LN's, then did a scan that showed nothing, then rads & Aromasin.  My original plan was to do more chemo after BMX but it was changed & the dr's considered my chemo was successful and that we should save it for later, if I need it.  I think a lot of us have wondered if we had enough tx, I know I have.  What made me feel better is, I've had 3 onc since this started and all of them have said I got the standard and they would have done the same....that gave me reassurance.

PlantLover

NancyD - I did go with my docs recommendation.  The only thing I did different was stop after 9 rounds of Navelbein instead of 12.  I was exhausted.

Jennygoog -  Yes, I know neoadj. chemo is very standard.  Again, not trying to make anyone think they didn't get enough treatment.

Just curious to see if I could find even one other person that did chemo before & after surgery, Stage III with lymph node involvement.  My very 1st post on the BCO forums was Oct. 9th, 2010 when I was thinking about stopping the Navelbein.  I couldn't find anyone back then that followed my treatment path and just thought maybe someone new might have joined us that had the same treatment.

Lucca06

My planned treatment on diagnosis was neoadjuvant chemo (6 x FEC-T), MX & ANC then rads.  However at the followup meeting with my Onc after surgery, it was decided as I still had some metastases in my lymph nodes that I would have 3 more doses of docetaxel.  It was me who raised it with them and her initial response was 'we did discuss that but decided you didn't really need it and what you had had should be enough.'  I think they agreed as my tumour had responded a lot more to the docetaxel compared to the FEC and so maybe with hindsight she felt I should have had 6 x docetaxel originally.  I know it was definitely not a common route here in England both at my hospital and in general.  Another lady I met, asked her onc about it after hearing what had happened to me and his response was 'no because you don't need it'.  She had a lot more nodes than me.

Kay_G

Plantlover, no worries!  You did not cause me to worry I didn't have enough tx.  I worried about that all on my own.  LOL  But I do trust my onc, so I trust her plan is appropriate in my case.  I know we all have individual differences, and chemo has its own risks and I have had some bad reactions to it.  That may have played into the decision for me.  It is nice to hear what others did/are doing though.  Thanks for starting the topic.

negirly

I did 12 treatments of Taxol/Herceptin (weekly)  prior to surgery then 4 AC after with herceptin for 1 year.  My onc wanted me to get herceptin ASAP so I was a little backwards. 

Karyn

Wordwrangler

I had a partial mastectomy then 6 rounds of chemo taxotere/cytoxan then 35 rounds of radiation. Now i'm on Tamox. I'm postmenopausal but couldn't do AI.

Ca1Ripken

I'm with kward starting with taxol/herceptin x 12 weekly before surgery... 4 DD AC also before surgery... nodes were clean after surgery, but T1 IDC left in breast (smaller than 1 cm).  No more chemo.  Rads + tamoxifen.  I'm guessing my Her2+ made my treatment plan different.  I have heard of others having chemo before and after surgery though. 

jennyboog

@Plantlover....You didn't make me worry about anything, I do that enough on my own with no help   I was just stating what my tx plan was. 

PlantLover

Thank you so much to all who posted.  It's nice to hear that I wasn't the only one that did chemo before and after. 

Not that it really matters, but I still wonder why my doc recommended Navelbein since I've yet to find  another Stage III'er that had that drug after TCH. 

Oh well, just like everyone ... hoping that we gave it our best shot the first time around.  

antonia1

 I had surgery first, followed by 4 AC followed by 12 Taxol plus Herceptin, Herceptin to continue for a year, followed by radiation and AI.

I wish I had neoadjuvant treatment. At least I would know if the chemo worked. The MRI and Pet scans performed after core biopsy showed 2cm tumor and not the actual 4+cm, so the surgeon decided on immediate  surgery.

Interesting thing is that when I contacted oncologist's office at SKCC for consultation, they told me that they set up  appointments only  AFTER breast surgery and not before, without even knowing the size of the tumor.

AnacortesGirl

I think the reason my docs at Seattle Cancer Care recommended adjuvant chemo for me was because of no response to neo-adjuvant and finding more lymph node involvement than we expected.  My local onc and I talked about it and took our time deciding if we would go with their recommendation.  Finally decided on low dose carboplatin.  But I only made it through 5 infusions before I got sick with a cold/sinus infection and all my counts tanked.  So that was the end of it.  I don't think it was a statement about my prognosis.  I think they were just concerned that the original chemo wasn't very effective for me.

Edited to add: BTW - carbo was the drug of choice for me because of the BRCA 2+.

giglgrl

I did a 4 month clinical trial before surgery than 6 rounds TCH after plus the one year of hereceptin. The trial I was in was for Her2 positives and it shrunk my tumor. Still had double mx as I had positive nodes as well.

Annaanne

Hi Plantlover:

I had six mos (a/c and taxane) of neo chemo, still a large tumor and one grossly pos node at surgery.  There was lots of discussion about whether to do more chemo, and at the time (2005) the consensus was that no studies supported more chemo.  I did go on to do rads and 9 more mos of herceptin (I'm her pos, obviously.)  I consulted a few different oncs.  Maybe the protocal has changed.  You might ask about studies and why navelbine. 

In any case, I'm quite well today.  Doing great.  

Hope this helps. 

Annaanne 

Kay_G

Thanks for posting. I had a partial response to neoadjuvant chemo. Onc called it a "good" response. Biggest tumor went from 4.5 cms (or 7 depending on whom I believe) to 1.2 cms and there were two lymph nodes with .2 cms. So good to hear someone without a complete response doing great so far out from surgery. I'm still doing herceptin. Hope it's doing it's job.

Annaanne

Yes, Kay -- I had a "disappointing" response to chemo, to quote my doc.  It was pretty grim at the time.  But that left the job up to herceptin, and I guess that's what did the trick.  No recurrance.  

You did have a very good respone and should continue to do really well.  Yay!

Take care

Annaanne 

Momine

I had 4 FEC before surgery and 4 taxotere after, as well as radiation (halfway through right now).

My onc said that the pre-surgery chemo is to kill any cells trying to metastacize. The idea is that if you operate first, the chemo may come too late. 

PlantLover

Thanks to all who have posted.  It's interesting to hear that there are others that had chemo before and after surgery.   Next time I see my onc I'm going to ask why he picked Navelbein.

7of9

I was officially diagnosed last week and my surgeon confirmed Thurs that it hadn't spread (beyond breast) but lymph nodes are a concern. She wants to try neoadjunct chemo before surgery to debulk the amount in my breast (2 masses, one over 2.5 cm and one just about a 1 cm). Possible something in the right breast but they can't find it on ultrasound so having an MRI biopsy.

 I HATE this waiting...I was hoping for a surgery date already...now I don't even see the onc until Weds though I am on a waiting list. Meanwhile this crap is growing in me. How long til he starts me on chemo and also my cancer pathology came back "very hormone receptive" so I'm thinking this may be good as it should respond to chemo/hormone suppreession therapy the surgeon mentioned? I hate that this stuff is hour by hour to try to take me away from my husband and 2 1/2 year old!!!!