triple negative bc-chemo before or after surgery

Clare82 - I had surgery first and mine was under 1cm, too.  However, in my situation the surgery was done based on a benign biopsy that showed atypical ductal hyperplasia. The surgeon wanted to remove the area in case there was any pre-invasive DCIS nearby. The triple negative invasive turmor was a surprise. I am now going through chemotherapy and will have radiation next.  To be honest, I was surprised the onc offered chemotherapy for the size of my tumor. It was my choice whether I wanted to go ahead with the chemo and I wanted to ensure I did all I could.  I'm halfway done right now. I'm from Canada so I can't recommend and support groups in the UK.  

Good luck!

Sherri 

Often chemo is done first to shirnk the tumour, so that breast concserving surgery (lumpectomy) can be performed. Obviously, at 6 mm that is not a factor for your mom.  However, surgery does  remove the cancer immediately and at stage 1 and 6 mm it is unlikely to have spread.

Another reason to do chemo first that has recently emerged is to see how the tumour responds to a chemo regimen; this can be a consideration for trip neg as it is the only systemic weapon we have, and studies have shown that those women who have a complete pathologic response (i.e. no remaining cancer is detected before surgery) have very good survival rates. 

Surgeons may tend to recommend surgery first; oncologists may lean to chemo. Sometimes your own scheduling and personal preferences come into play too.

It is a struggle when doctors give you different opinions, but often it's because there's no absolute right or wrong way.  More than one good option exists. If there's a doc who makes you feel most confident, go with that.  

Hi Clare,

As you can see I am in the UK, in the South. You can get excellent support through BCO( here), despite your location so it's great you have found this place. I am sure sometime you will want to talk to someone.

You could try: the PALS service in the hospital, they will recommend the support groups nearer to you.

You can "google" and find MACMILLAN on the web. Your should be able to talk to a councelor on the phone there and be signposted to the best options for support in your area.

Your mom can ask  anyone on her medical team to refer her to the macmillan nurse service. It is free and the experienced Macmillan nurse that will be appointed to her will be someone she can contact anytime she is concerned confussed or nervous about anything or needs support. She should be able to help you too, and explain things to you.

You can also "google" and find the "Haven centre",give them a call,they have one centre in London and one centre up north I think. THey have a very wide range of services for your mom, and they are a very calm and welcoming place commited to helping woman affected by BC in a great number of ways, they may well be able to advise you and could be a great resource for your mum. This is free, in fact all the services above ae free.

Honestly, the start of this "journey" is the most scary, there is all this unkown and uncertainty, keep asking questions, once you understand your mother's particular diagnosis, and treatment plan, and how it is going to be sheduled, hopefully you will start to feel better as you will be starting the phase f getting on with the "work" to make your mother better, that is a better focus then all this fear of the unknown which is the worse part right at the start.(But it is totally normal)

You are quite right, you know and feel that you need the support and you must go out and get it for you. That will benifit the both of you tremendously and I am sure that the confidence and calm you will gain from getting support for yourself will make you far more able to support your mum. But keep talking to her too, she doesn't expect you to be super strong all the time.

You take good care of yourself.

Shiny 

Hi Clare - firstly I am really sorry about your mum!

I am in the UK too and would like to confirm what shiny has said above - I have the Breast Haven Centre near me in the North of England and it's great. The MacMillan Centres are good and your mum should have a Breast Care Nurse who should be able to help too. I have a sixteen year old son and all the facilities they provide are available to support him too. So you are not alone. As for chemo before or after surgery - I had chemo BEFORE surgery. I was recommended this course of action because, as they only have chemo to treat triple neg cancer, they could monitor how the cancer responded via MRI's at regular intervals. If the cancer was not responding to chemo they could switch to a different one (there are lots of chemos to chose from). Unfortuntately for me, the cancer did not respond to four different types of chemos and my treatment was withdrawn half way through. BUT at least I was made aware of this and I was not being subjected to this treatment when it was not helping the situation with my type of cancer. However, MOST triple neg cancers do respond very well to chemo! I suppose it is a matter of choice for your mum - for me it was sometimes hard to have the tumour sat there and some women just want to get the tumour out ASAP. But I personally would do the same again. For me, having chemo first gave me and the specialists more information about how my cancer was responding to treatment and action could be taking accordingly.

Sending you and your mum best wishes X.