Neoadjuvant Chemo & Surgery Options

elise24601

I was wondering if anyone who did neo (before surgery) chemo ended up effectively shrinking their tumor to the point of being able to change their surgery options for less breast tissue removal.

I've heard that some women get away with a lumpectomy rather than a full mastectomy. I don't think that's in the cards for me as I am starting out with a 2cm and a 3cm tumor, but I would love to be able to do a skin/nipple/areola sparing procedure. Also hoping maybe less nodes will have to be taken if I have successful results with chemo. Again, I'm realistic and know they will have to at least remove the sentinel node(s) but I'm hoping to avoid the complete aux dissection. Does this type of thing ever happen?

I'm on round 2 of TC and have already felt much less hardening/thickness in the cancerous breast than I did at the time of diagnosis.

Please share your experience!

hoosier238

Hi elise24601, yes these are exactly the kinds of adjustments that can be made for surgery after neoadjuvant chemo. If your response is sufficient, then skin/nipple sparing mastectomy + SLNB are possible. The one factor to watch for is if you had nipple retraction prior to starting chemo: that indicates that the nipple tissue will have to be removed. Otherwise, make sure you discuss your goals for surgery with your surgeon (sooner rather than later so that everyone is on the same page).

ElaineTherese

Hi!

I had a 5 cm+ tumor, and it was wiped out by neoadjuvant chemo. I opted for a lumpectomy instead of a mastectomy. I had one compromised node, and that was cleaned out by chemo, too. But, my team forgot to keep track of which node that was (did a fine needle biopsy and so did not insert a tumor marker). So, I ended up having all 20 Levels 1 and 2 nodes removed. Thankfully, I did not develop lymphedema, but I was kind-of mad that they had lost track of the compromised node.

Do you know whether any of your nodes are compromised? If so, make sure your team inserts markers so you don't end up with an ALND if you don't need them all out! Hope neoadjuvant gives you more surgical options!