Chemo prior to Surgery?

MEandJax

I am recently diagnosed with IDC in my left breast. ER pos, PR neg, HER2 neg

I have heard and read that some women have to have chemo before surgery.

Can I as a patient say I want surgery first? I would like to get this 3.3cm tumor out of me now.

Any thoughts or words of wisdom are appreciated.

Thanks everyone.

eviec1

With ER+/HER2 neg, you may not need chemo at all. So there's a good chance they will want to go straight to surgery anyway.

Melbo

chemo first is usually for HER2+ or triple negative, the other types generally get surgery first and chemo after if they need chemo. But as evie said — you may not need chemo at all depending on the grade of your tumor and other factors

exbrnxgrl

Hi,

Your diagnosis line is not public but if I recall correctly you are stage II per biopsy. Neoadjuvant chemo has become more common lately but it depends on your particular bc. Has your oncologist laid out a proposed tx plan yet ? I don't think it's really a patient choice (though you always have the option to say no to anything) but rather an approach based on an individual's bc. In some cases it is advantageous for a patient to have chemo first so again, it’s a medical recommendation not something a patient chooses. If it's any comfort, getting the tumor out immediately is not terribly important. Most bc is slow growing and those who do chemo are treating their bc, so something is being done. I understand the feeling of just wanting it out but whether surgery is done first or chemo is done first you are still treating your bc. What does your mo say?

MEandJax

Thank you, this is very helpful info. I like the idea of knowing that something is being done.

I really appreciate everyone's answers.

I changed my diagnosis to public now. I didn't realize it was private.

Sorry, what is mo?

exbrnxgrl

mo=medical oncologist

Here is a link to a good list of abbreviations you’ll commonly see:

https://community.breastcancer.org/forum/131/topics/773727?page=1#idx_1

MEandJax

Great thank you again.

I'm seeing my oncologist tomorrow.

mattmandypaige

Hi MEandJax.

Just wanted to say hi. I am in a very similar situation as you. IDC, Left 4cm, Grade 2. Still waiting on the ER/PR/HER results. I see my oncologist to go over my treatment plan tomorrow. How did your appointment go?

Emily21

Depending on the size of the tumour, chemo can be done first to shrink the tumour in order to enable a lumpectomy to be performed and thereby preserving the breast. It is also a way of finding out if the tumour is responsive to chemo as if the tumour doesn't shrink it will likely be more sensitive to hormone blockers. The oncotyping will aid in the Descision. Best of luck, whatever the treatment, it will be tailored to suit your needs.

MEandJax

Thank you all for the response, I really appreciate the help thinking this through.

Imet with the oncologist on 7/7/21. This is what he told me:
Next step is to meet with surgeon. I'm going to go with a lumpectomy vs mastectomy, which will be less down time but require radiation. I will also have to take an anti estrogen pill for 5-10 years. Surgeon will check sentinal lymph nodes during surgery, which will tell what Stage the cancer is. Surgeon will also send lump out for Oncotype test, which will determine if I need chemo or not. If chemo is needed, that comes before radiation. Chemo would be 4 months every 3 weeks. Radiation will be 5 days a week for 4 weeks, which can cause skin soreness and weeping. He said that mastectomy or lumpectomy does not factor into or guarantee that cancer won't return.

I have two appointments coming up next week. The first with the surgeon on Wednesday and the radiologist on Thursday. Friday they (oncologist, radiologist, and surgeon) all meet on Friday the 16th to discuss our visits and determine the "Final treatment plan". So it could change. They also include the mammogram doctor, biopsy pathologist and my breast health navigator. The navigator set the appointments up and will call afterward with the info. I asked her to call even if nothing changes from what the oncologist said. The navigator is assigned to help me.

AliceBastable

Good luck! Be aware going in that plans can change based on pathology. I was supposed to have 22 radiation sessions, but because there was a micromet in my sentinel node, it got changed to 33 sessions. So keep your mind flexible from one step to the next.

MEandJax

AliceBastable

Thank you for the heads up. I appreciate it.

MEandJax

Mattmandypaige

I forgot to say hi back.

I hope your treatment plan is doable for you.