Adjuvant vs. Neoadjuvant Chemo

imallright

My MRI shows tumor in left breast to be about 4.7cm. with 3 abnormal lymph nodes. Axillary node biopsy came back positive. I had decided on bilateral mastectomy with reconstruction (scheduled for Nov. 5),and would then have chemo and radiation. With this new biopsy result I can choose to have chemo before surgery-which may (or may not) keep me from having to have an axillary dissection at the time of surgery. With surgery scheduled before chemo an ax dissection is certain. Greater chance of getting lymphedema (which freaks me out) with an ax dissection.

On the other hand-I want this thing out of me asap. The pain started 5 months ago, and has gotten more pronounced and spread to almost the entire area of my breast. The doctors says the tumor is central with spiculation to my nipple. My breast has gotten larger, and it feels to me like the tumor is growing.

What would you do? Adjuvant, or neoadjuvant?

Mamiya

One advantage to chemo before surgery is you will know if it is effective or not, and if not your doctor can try a different one. After surgery it is much harder to know.

wrmbrownie

I did chemo before surgery. I like seeing whether chemo made a difference or not. I've read some people had the chemo completely remove all tumors (and in the nodes.) I didn't want to have to worry about surgery recovery and chemo at the same time. It's bad enough dealing with all the drainage tubes etc without having to worry about being fatigued.

ruthbru

I was just talking to a friend today whose sister's tumor was so large that they couldn't even do surgery. After Neoadjuvant chemo, the tumor had shrunk down to literally nothing. She was able to have a lumpectomy, and they had to refer back to her original mammogram & ultra sound to know where to remove tissue. Of course, that isn't a guaranteed result, but definitely worth a shot, I think.

(This wasn't a choice when I was diagnosed; but if it had been, it would have been what I would have preferred to do.)

Skittlegirl

My surgeon said chemo first for me. One benefit is any circulating cancer cells will get targeted by it. He also did not want there to be a complication from surgery that would have delayed my chemo starting.

ElaineTherese

I did five months of chemo before my surgery. It wiped out the active cancer in my breast and compromised node. As a result, I could choose a lumpectomy in which a small amount of tissue was removed from my breast.

Chemo wasn't a picnic, but it was nice to watch my lump get smaller and smaller until I couldn't feel it any more. I feel confident that my MO chose the right chemo for me. Best wishes!