chemo before surgery??

estark · March 2010

I was diagnosed in July with the HER 2+ breast cancer, the tumor was 4 cm and two lymph nodes were palpable and highly likely to have cancer in them. We were trusting our docs and they suggested the chemo first and then hopefully could do a lumpectomy if the tumor shrunk. We did the chemo and while we had a great response, there were still tiny bits of cancer through the breast and you couldn't get clear margins without doing a mastectomy. So, we did that. Now, after getting more info from someone else, we are afraid that our doctors might have advised us to do the chemo first so that we would be able to do their clinical trial. Was there a risk that the cancer could be spreading during that 8 months of chemotherapy? Should we have done the surgery first? We weren't that interested in saving the breast anyway, we just wanted to do what was best to get rid of the cancer. Now I wonder if I should get a second opinion for the remaining piece of the treatment. I still have to do 5 weeks of radiation and then finish the Herceptin and start Tamoxifen at some point. Any advice?

orange1 · March 2010

Chemo before surgery is very common/accepted for larger tumors. Starting chemo before surgery enabled the killing of any potential stray cancer cells that may wave wondered away from your breast without having to wait for you to heal from surgery. The bonus of neoadjuvant therapy vs. regular adjuvant therapy is that you get to see how your tumor responded. It sounds like it was very sensitive to chemo. Congratulations.

Regarding second opinion. Do what makes you feel comfortable. In my opinion, if your doc nuked the h**l out of your tumor, and it withered away while you survived it relatively unscathed, you had a good outcome. That said, it helps if your doc is someone you feel comfortable with and it sounds as if perhaps you aren't too comfortable with this one.

Good luck.

1marmalade1 · April 2010

I too am having neo-adjuvanat chemo. My tumour was 5cm+. I did two rounds of A/C - after an ultrasound it showed the tumour had possibly GROWN - they ditched the rest of the A/C treatment, and put me straight on Taxotere/Herceptin. I am also Her2+. After 4 txs, my tumour has now shrunk, although I don't know yet by how much - have to see the onc again in 2 weeks. At least no extra time was wasted on the A/C, since it wasn't doing anything to either shrink the tumour or take care of the cancer. Surgery will be the next thing - lumpectomy definitely out of the question - have to talk to onc about option of uni- or bi-lat mastectomy. Neo-adjuvant is a good option for larger, more aggressive tumours - good way to tell how the chemo responds.

kimmie68 · June 2010

I had chemo first as well. As far as the dr's doing it for their clinical trial, that I am unsure of because they had to have my permission to use me in the trial I am in. I would think this would be the same for all trials. I got the thought that this is what bothered you the most in your post, please ignore if that is not the case. I am glad though that you have come through surgery. As far as 2nd opinion goes, you have to do what is right for you, especially if you are feeling as if the dr's somehow deceived you. I hope that this is not the case and I am sure they gave the advice that was thought best for you. Good luck and hugs.

roz123 · October 2011

this post is for marmalade1 from brampton ontario, would love to know where you are being treated. I am also doing chemo before surgery. Had the same issue as estark was worried that the onc suggested this because of a clinical trial that the hospital is currently involved in. I was told this was the protocol because of my HER2 status and it being aggressive

chemo before surgery??

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