need advice on treatment or surgery

becky1 · February 2010

Tuesday I will complete my 4th cycle of A/C neoadjuvant treatment...My onco wants me to do a 12 course of Taxol (which a book I have says only works 50% of time anyway) before he will consider surgery again. I just saw my surgeon though and he feels that the tumor has shrunk enough to go ahead with my masectomy then follow up with radiation. I had ct scan but was denied PET scan from insurance co. until now. My 1st PET in the 15th(which the surgeon reordered, not onco). PET should further prove if surgery is a def. option. My concern is that the onco is following routine without considering what is best for me. The surgeon feels removing the tumor is best for survival, and Komen website says that a meta analysis of 8 studies shows that there is no difference in survival rates in those that did or did not do neo treatment before surgery. I am so confused on what to do. I want the tumor out of me but am afraid to go against onco.'s advice in fear of jeopardizing my outcome. My breast is still inflammed since Oct. and onco wants me off antibiotics, the only thing keeping the inflammation in check. So if you were facing these options, what would you do? Continue treatment with Taxol or have masectomy then radiation? Thanks so much. I will do what my heart leads me to do in the end but it will be nice to know others opinions!

Getar · February 2010

Hi Becky, I too, am new at all this. However, my surgeon tells me that I need the surgery first, then see the oncologist. They don't have all the pathology reports until surgery is performed. I have chosen the double mastectomy at this time.

becky1 · February 2010

I had biopsy but no clear margains to proceed with masectomy. Tumor was 8' at time of biopsy, no definite stage until after surgey and node removal is what I'm told, and I feel overly anxious knowing that I can now have the surgery and the onco wants me to wait. I wish I REALLY knew what the best choice for me is.

Good Luck Getar... I will pray for you

Ezscriiibe · February 2010

My breast surgeon followed my lead. I wanted the damn thing OUT, and that's what he did, took it OUT.

Now I am proceeding with medical oncologist and radiation oncologist AFTER the lumpectomy to remove the tumor.

Mental health wise, there was no option for me. I could not leave this monster inside of me.

Now I can make my FINAL decision, bi-lateral or no, without the added pressure of KNOWING that the cancer is still alive inside of me and possibly growing or moving along causing more damage somewhere else.

I know you will have a tough time deciding, but it's like I always say, you have to make the decision that feels right to you. Trust your gut.

CMT · February 2010

My medical oncologist also wanted me to have neoadjuvant treatment but I told him I wasn't comfortable going 5 months before having surgery. Plus my surgeon had told me something different - he was recommending a lumpectomy but wanted me to have the BRAC test and if it came back positive his recommendation would probably change to mascectomy. However, he didn't want to do "nothing" while waiting on the results and thought it best to take this time and shrink the tumor with 4 cycles of chemo. Everyone compromised and we "sandwiched" my chemotherapy. I had 4 cycles of A/C (2 months), the lumpectomy, and I just started my second half of chemo last week which is the Taxol and Herceptin (diagnosed HER2 positive) for 12 weeks and will follow this with 6 weeks of radiation. Not sure if "sandwiching" is an option for you or not (I had one lymph node involved). Just as an fyi...my BRAC came back negative and when they went in for the surgery the tumor was gone and no signs of cancer in any of the lymph nodes they removed. God definitely does hear and answer prayers! God bless!!

mawhinney · February 2010

Why don't you get copies of all your records, tests etc and seek a 2nd opinion. You might try a cancer center where the doctors use a team approach. Working as a team all the doctors meet to review your case and come to an agreement on the best line of treatment for your particular situation. With the team approach there is generally a nurse oncologist that acts as your guide and coordinates appointments and tests.

rayofsun · February 2010

i was dx'd in oct 2009, did 4 cycles of ac over 8 weeks with good results and now have received 7 of 12 taxols, then will be surgery and 6 weeks of radiation. I will be having a bilateral masectomy. I did gey 2 opinions from breast surgeons and not onco and was told I am one the right track.

rayofsun · February 2010

becky what part of the country are in you?

AnnNYC · February 2010

Becky, I just wanted to add support for your gut feelings. I think it's a good point you make about the meta-analyses showing no difference in survival rates for the surgery-first and surgery-later groups. I think your condition of ulceration is an unusual one, and I can understand your and your surgeon's thoughts about it being time to remove the tumor. I'm no expert, so I'm a little afraid of being overly persuasive, but... are your surgeon and your onc discussing this with each other?

Faith316 · February 2010

Like someone else said above --- if it was me, I would go to a major cancer center for another opinion. You have nothing to lose by doing so.

need advice on treatment or surgery

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