Neoadjuvant vs adjuvant vs surgery

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JeanneG
JeanneG Member Posts: 20
edited June 2014 in HER2+ (Positive) Breast Cancer

Just dx this month. 6cm stage 3a HER2+ ERPR- and breast conservation not a primary goal. I am 56 and insulin dependent diabetic otherwise pretty healthy with EF of 60. No history of CA in my family.  I think I want the neoadjuvant chemo to get Herceptin right away.  All negative scans for met but I know cells can be there and not evident.  Recommended plan is chemo/Herceptin first, then bilateral mastectomy, then more chemo and radiation.  I know this is agressive and I want to treat aggresively.  Has anyone faced this decision that can share how they decided?  What about the combo chemo/dose dense?  THANKS for sharing.  This looks like a GREAT site and I think consumers are the most honest about what's working without bias.  It's wonderful to read the survivor stories.

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  • lexislove
    lexislove Member Posts: 2,645
    edited October 2009

    Hi there.

    My tumor was 8cm, and I was given no choice.....I started with chemo,ACT, then had my mastectomy. The goal is to shrink the tumor so they can get clear margins OR a lumpectomy. I chose a mastectomy and I do not regret my decision.

    A big plus to doing the chemo first is you and your docs can see how well the chemo is working making that cancer shrink and hopefully disapear.

    It was rest assuring for me to see my tumor melt....I know my chemo killed it and my path report at the time of my mastectomy proved it.

    Sounds like your docs know what they are doing. Chemo before surgery is becoming more and more commmon. It was originally done for large tumors but woman with smaller tumors are doing it now, to avoid a mastectomy and have the lumpectomy.

    There are many woman on here who have done the chemo first thing.

    Welcome to the boards...sorry you had to be here, but the woman are great. Be well.

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  • TriciaK
    TriciaK Member Posts: 362
    edited October 2009

    Hi,

    At just under 2cm's my tumour was'n t too large but I still believe as her2+ we need to throw all we can at this first time around.   I did the dose dense a/c x4, followed by herceptin/taxol x12 with rads and had a lumpectomy. I also had an ooph and take arimidex.  I'm four and a half years out but have some worry now with a recent bone scan showing a suspicious area.

    Do all you need to now would be the advice I'd give, this disease is so sneaky we just can't take a chance.  Good luck!

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  • digid
    digid Member Posts: 65
    edited November 2009

    Hi Jeanne-

    I was diagnosed halfway through October and had a double mastectomy a week later (Oct.22) - no time to consider pre-surgical chemo!  All my docs seem to think that this is the right order for operations, although I'm a bit anxious that I should have done chemo first.  I noticed, though, that you are an insulin-dependent diabetic.  I have had Type 1 since I was 12 and I am pretty nervous about starting chemo in the next month or so.  Can you let me know what impact the chemo has on your blood glucose if you do choose to do chemo right away?  I'm rather worried about what the chemo and/or the steroids might do to my hard-fought BG control.  It is SO hard to find info about this online... thanks and I hope your journey is smooth and successful. 

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  • ICanDoThis
    ICanDoThis Member Posts: 1,473
    edited November 2009

    My husband, who is a Type II diabetic, recently completed several rounds of Cisplatin, Taxol and 5Fu (esophageal cancer). He has been completely diet-controlled for 20 yrs - lost 100 lbs, and rearranged his diet and exercise. 

    His oncologist put him on insulin because of the steroids - he basically went from normal to insulin dependent in the week after his first treatment. But he had no trouble with nausea, so they dialed back the steroids every round, until at the end he was getting almost no steroids, and was off insulin again.

     Hope this helps

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  • lovetosail
    lovetosail Member Posts: 544
    edited November 2009

    Hi all,

    (I also posted this in another forum, sorry for the repetition but I later realized this forum might be more appropriate) - I am ER+/PR-/HER2+ and have the chance to participate in a neo-adjuvant clinical trial with 3 arms: (1) TCH (2) TCH+Ty (3) TC+Ty - you are randomized to an arm.  In each arm, 6 cycles of treatment, then surgery, then herceptin alone for 7 months.  Would you do it?  Why or why not?

     thanks very much for your insight and experience,

    Best,

    Sue

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