Hello, new here.

DaisyK

I was diagnosed in March with Invasive ductal breast cancer. Estrogen and progesterone positive, Her 2 negative.  I have a large tumor approximately 4 5/8 cm and at least one lymph node involvement-the node was biopsied along with the tumor. I'm currently waiting for genetics testing to come back. Two of my sisters had breast cancer, one is fine now, the other died from ovarian cancer 20 years after the breast diagnosis. So family history is strong. Both my sisters were pre-menopausal. I am 57 and post. I thought I had dodged it.  If I test positive for BRCA, the surgeon recommends bilateral mastectomy. I'm hoping it's negative. Anyway, the oncologist is setting me up for neoadjuvant chemo. She feels if we do the chemo first, there is a possibility the surgeon wouldn't have to take the entire axillary area. But in the same breath, she has said that my cancer is 80 percent estrogen based which responds less to chemo than the negative hormone type. But it sounded like an ok plan until I googled and found articles that stated evidence of neoadjuvant chemo fueling metastasis. It was only one study, but it spooked me. Anyone else have chemo before surgery? I am also somewhat concerned with being in a weakened state after chemo and then having surgery. Oh, the oncologist also said that if my tumor shows any sign of growth during chemo that we would schedule surgery straight away. So they will keep an eye on it. Thanks in advance for any input!

wrenn

so sorry you have been diagnosed. It is a lot to take in but this site is great for information and support. What I have read about chemo first was that it lets you know if chemo is working whereas if you do suregery first you won’t know. It also makes the surgery easier if tumour is smaller.

Hopeful for you that you are negative BRCA

Ask lots of questions here and be good to yoursel. It is a stressful time

Anonymous

Welcome to the club no one wanted to join in the first place!

Lots of women get chemo before surgery, and I'm hoping they will chime in soon and share their experience and strength.

ER+ may not respond so well to chemo (not sure about that actually) but it responds much better to anti-hormonals--in pill form--that can help protect from recurrence. And ER+ seems to be less aggressive, so take heart in that, too.

We are here for you.

Hugs,

Claire in AZ

Anonymous

About chemo fueling metastasis--be careful what research you read. In these early days I'd advise not to consult Dr. Google, who is notoriously wrong, uses pseudo-science, old research, and tiny studies to try to prove truth.

Yes, chemo doesn't always work, but if it actually caused cancer to spread, oncologists wouldn't be using it, since they'd be setting themselves up for massive litigation.

Have you considered getting a second opinion from another oncologist? Or asking for a biopsy and getting an oncotype test done on the tumor (to see how it responds to chemo) before you actually get chemo? Those might be options.

Claire

Shellsatthebeach

I had chemo first. It made it much easier for the surgeon to get clean margins since my entire left side was "very diseased". I had 4 tumors and also it spread to my lymph nodes.

Beesy_The_Other_One

Daisy,

Even 25 years ago when my mother was diagnosed and her surgeon and MO told us that they wanted to do chemo first, I remember asking, "Why not just cut it off?" This was when neo-adjuvant (before surgery) chemo was not commonplace. He explained that the tumor, which had never before been exposed to chemo, is affected greatly by it and your body's immune system also recognizes there's a problem and goes to work also. It's a very simple explanation, but it stuck with me all these years. She was estrogen positive and had NINE positive nodes after the first twenty weeks of chemo (went on to do another twenty afterward). She is 81 years old and no recurrence. You can see my stats below--my tumor was gone when they did surgery, and it had grown to be quite large before we started chemo. The pathology report states that all they could find was a tumor bed (where a tumor was) and the clip placed at biopsy. No live cancer cells. I think your doctor is wise to start with chemo.

Beesy

Salamandra

Hey DaisyK,

As others have said, there are is good evidence/science to back up the approach your doctor is recommending. That said, it can be very helpful/reassuring to get a second opinion. It's recommended especially if your first opinion isn't at an NCI designated center. Health insurance companies cover this and often encourage patients to get one. They may even have a navigator to help you set it up, if it's something you're interested in.

DaisyK

Thanks so much to all who replied! My genetic testing came back negative, so yay for that! I had a meeting with the oncology nurse at the hospital today and I'm feeling better about the treatment plan. Again, thank you all so much for the input, I really appreciate it.