neoadjuvant chemo in stage 3?

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geewhiz
geewhiz Member Posts: 1,439
edited June 2014 in Stage III Breast Cancer

I was just reading something recently published by my hospital stating that stage 3 gals that did NOT receive neoadjuvant chemo prior to surgery are at an increased risk of recurrence. If tumor is present at surgery it increases the recurrence percentages.

HELLO? Why did they move me straight to a mastectomy? Now I am really worried! Does anyone have any knowledge they can share to keep my nerves calm? Good days and bad days, eh?

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  • krcll
    krcll Member Posts: 343
    edited June 2010

    I read that the survival and recurrance rates were the same with neo- and adjuvant chemo. Is this new info? I also had my operation before chemo and would like to know...

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  • AnacortesGirl
    AnacortesGirl Member Posts: 1,758
    edited June 2010

    I can't point you to a particular study that compares the two.  But one of the main benefits of neoadjuvant is to see how cancers respond to chemo.  In both of your cases you are her2 positive so they already know that your chemo of choice is going to be herceptin or tykerb.  So I'm guessing they felt comfortable taking you right to surgery.  As opposed to the other combinations which have varying responses to the different regimens.

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  • KerryMac
    KerryMac Member Posts: 3,529
    edited June 2010

    I believe (unless there is very new data) that outcomes are the same.

    I thought they generally used neo-adjuvant Chemo if the tumour was too big to remove with clean margins (or attached to chest wall, etc) or they wanted to shrink the tumour for a lumpectomy.

    This article says the same...

    http://www.healthcentral.com/breast-cancer/c/87/10563/breast-cancer 

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  • kimber3006
    kimber3006 Member Posts: 586
    edited June 2010

    My BS told me the same thing Kerry said.

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  • Frankie_
    Frankie_ Member Posts: 422
    edited June 2010

    I have also wondered about this too. Initially upon my mammo and ultrasound it was thought my 2 tumors were 1.8 cm & .8 cm. After surgery I was told the tumors combined were 10 cm. Had a lumpectomy followed by a mastectomy due to margins not being clean. I am hoping the chemo did it's job as surgery was done prior to chemo.

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  • fightinhrd123
    fightinhrd123 Member Posts: 633
    edited June 2010

    I dont think it would improve survival rates, i think it just gives you a better idea if the chemo worked???  I have friends that had neo that still had tons of pos nodes after chemo, and some that had CPR.  Those with extra nodes got more chemo after surgery.

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  • peacelovedogs
    peacelovedogs Member Posts: 57
    edited June 2010

    I know with Inflammatory Breast Cancer (always IIIB or higher) neoadjuvent is now protocol.  They learned within the last several years that IBC responds better that way (??).  I'm so thankful because it has increased my chances BIG TIME.  Anyway, maybe it had something to do with IBC?

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  • lauri
    lauri Member Posts: 267
    edited June 2010

    According to a conference I recently attended, there is NO difference in  survival outcomes depending on the order of treatment (surgery first or neoadjuvant chemo first)  The neoadjuvant chemo just lets them know whether the chemo had effect.  

    Neoadjuvant allows quicker analysis of clinical trials since they can see an actual effect (reduction in tumor size as shown by surgery) vs having to wait to see results over 5 years of following patients -- thereby enabling researchers to fine-tune which drugs work for which kind of patient.

     I didn't have neoadjuvant in 2006 -- still NED at 4 years.

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  • nowords
    nowords Member Posts: 423
    edited June 2010

    I had neo-adj Dose Dense AC x 4...because of the size of the tumor 10 cm + ....pathology showed no response and I had 7 of 22 nodes positive ... I was treated at Mayo Rochester.

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  • SusieMTN
    SusieMTN Member Posts: 795
    edited July 2010

    geewhiz  I had neoadjunct Chemo, but they could not get clean margins.  I had 6 months of chemo starting with Taxol and Herceptin weekly and FEC once every three weeks. I was pretty wiped out by the end and just ate and slept but I made it thru! I was lucky as there were only a few cancer cells left when I did have my MRM.

    So I believe what KerryMac said is correct. 

    Good luck on your journey!

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  • Kodapants
    Kodapants Member Posts: 139
    edited July 2010

    My situation id different.  I did have NeoA with AC+T then surgery.  I did not respond well and required 3 more chemos in a trial right after surgery.  If I would have done surgery then AC+T then I would have been out of luck.  NeoA did take care of the nodes as I was positive before NeoA but not after.

    Best of luck,

    Koda 

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