Question????

There are several reasons to do chemo first.  One is that it may allow for a lumpectomy if that is what the patient wants.  By shrinking the tumor, you can get better cosmetic results.  Another reason is it is a way of seeing if the chemo works.  As someone who had surgery first followed by chemo and was Stage IV in just over a year after finishing treatment, I'm sorry I didn't have chemo first.  I will always wonder whether the six rounds of chemo did anything.  If there was a tumor to monitor, you can change or adjust the chemo.  The oncologist had suggested doing chemo first, but the surgeon felt surgery was a better option and I went with the surgeon's recommendation.  These are good things to discuss with the surgeon and oncologist and get all the pluses and minuses.

I had chemo first, i had a 7cm tumor and lymph node invovlement. I believe my node involvement was the reason for the immediate chemo at least in my situation.

I am Triple Negative, my tumor was between 4-5 cm. I am doing Chemo first. The tumor is already smaller, which  gives me the option  for a Lumpectomy. The first surgeon I went to said Mastecomy, Chemo, Rads. I went for a 2nd opinion at a Cancer Center and they  gave me lots more information and options. I feel good about my decision, I think we are going to see more and more of this as we see advances made in Breast Cancer.

Best of Luck!

Sandy

I had surgery first also...then chemo 6 weeks later..it would have been nice to have it first to see if it was working but then again I was glad to have the lump out so quickly.   I don't know..I think either way is fine....I do think that it depends on the size and what type of surgery and node involvement also.even though I hated chemo it was good to know it was going through my entire body and not just the tumor area.

I have read that the usual rationale is for tumors over 2 cm chemotherapy is given first, for those less than 2 cm in size the tumor is removed, then chemo is given. I had my surgery first (1.7 cm tumor), but sort of wish I could know how my cells responded to chemo.

Kathy

Hi Titan,

Yes, I have had three clean mammograms now ~ one at one year, one at two years then they wanted a 6 month, which was this month and it was "c/w changes considered to be benign." Just don't like that wording. I had my annual breast MRI on the 8th of July and am still waiting for those results. I have my annual appt. with the rad. onc. tomorrow so I will make sure she has those results. No news is good news ~ right??

Kathy

Hi Titan,

"c/w" is consistent with, sorry. I saw my rad. onc. today and the MRI was unchanged from 1 yr. ago...only changes due to the lumpectomy. I had an annual mammogram in 1/2009 then 1/2010. This past January they wanted a 6 mo. follow up and it was "unchanged, consistent with benign findings." A few microcalcifications and surgical changes. I just want it to say NORMAL!

Guess it won't ever say that : (

So now next mammogram is 1/2011. May not need any more breast MRI's, which I am fine with. Too many false positives with that test, in my humble opinion.

Have a great day everyone! It's a very hot one today in Maryland.

Kathy

Survival rates for both are the same, whether it is before or after surgery the chemo is administered, there are advantages of both treatments, i had surgery first but the surgion had to argue for it, she was afraid that chemo would not work as tumour was acting so strangely and was so quick growing, i had two lumps but turned out to be a large tumour that had grown along the chest wall, the scans showed nodal envolvment and one tumour of over 2cm and the other of about 6 cm and it turned out to be one large tumour over 8 cm, if i had the chemo first i would never have know that my nodes were clear as they were enlarged probally from infection.

the advantages of chemo first as i see it are that they know if that particular chemo works for you, it is also easier to get clear margins if the tumour shrinks and you are facing chemo before the trauma of surgery so are fresh going into it. the advantages of chemo after, is that physicology you know you have the first big step completed, the cancer in the main part is gone out of your body (hopefully), you may need less chemo as they will be definite about nodal status etc. you also wont feel like crap from the chemo going for surgery and healing ability wont be impaired.

Hey Angels..I've missed you!  Good to hear from you but it sucks about the stage 4...what kind of treatments are you doing now?