Why some need chemo after surgery, some not???

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Karina121293
Karina121293 Member Posts: 370
edited June 2014 in Stage III Breast Cancer

Hi ladies. I had surgery on 21.01.2011 , had 4 rounds of neoadjuvant chemo and now my onco says I need another 4 rounds of chemo. Does anyone stage 3 had the same case??? Thanx everyone for sharing your stories and all the best.Hugs xxxxxx

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  • americanpinay
    americanpinay Member Posts: 338
    edited February 2011

    Hi Karina,

    I did not have neoadjuvant chemo, just adjuvant chemo.  I think adjuvant (after surgery) chemo is recommended 99.9 percent of the time, if not 100 percent, for Stage 3. If I remember correctly, I read that neoadjuvant chemo is not prescribed as often as adjuvant chemo.  I believe neoadjuvant chemo is commonly prescribed for IBC or if the doctor wants to shrink a huge tumor before surgery.

    I wish you well in your treatment. Chemo really is doable. At the risk of sounding trite, this too shall pass.  Hang in there.

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  • lago
    lago Member Posts: 17,186
    edited February 2011

    Karina I am stage IIB. I didn't have have chemo before surgery but I did 6 rounds of chemo after surgery. When you think about it you are only doing 2 more rounds more of chemo than I did. I know many women that were stage IIA that 2 rounds less than I did.

    The amount of chemo you are getting overall doesn't seem out of line but I'm no onc. Just my opinion based on what I see.

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  • NancyD
    NancyD Member Posts: 3,562
    edited February 2011

    Karina, 

    I had four rounds of neoadjuvant TAC (Taxotere, Adriamycin, Cytoxin), then a BMX, and then two more rounds of TAC. I don't think your treatment sounds very out of line, either. There will always be differences in treatment plans based on your diagnosis and your oncologist's practice. Medicine is a good dose of science with a fair amount of art thrown in. 

    The best oncologists tailor treatment for the individual, so if you don't find another person on this board who had the same chemo plan, don't be discouraged. It sounds like your onc has put together a good plan for you.

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  • Latte
    Latte Member Posts: 1,072
    edited February 2011

    hi karina,

    I only had neoadjuvant and a complete pathological response, so i can't help you. but there's another thread somewhere here started by "nannababy" - she was asking the same question and there is a lot of input and info on that thread - i suggest you try to find it or PM nannababy

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  • MinAZ
    MinAZ Member Posts: 368
    edited February 2011

    One of my friends was stage III b. She had neoadjuvant, sincle mast, then adjuvant chemo but I don't remember specifically what she had each time. Then she had radiation.That was about  4 years ago and she is doing well.

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  • SusieMTN
    SusieMTN Member Posts: 795
    edited February 2011

    Karina Hello!

    Did they get clean margins?  How much did your Chemo shrink your mass?

    I am stage 3 also and had a 11 cm mass.  Surgery was not an option until Chemo reduced the size of my tumor(s).  I was told at the beginning if they could not get clean margins I would have Chemo after my mastectomy.  So I had 6 months of Chemo 12 Taxol and Herceptin and 12 every 3 weeks of FEC.  The Chemo did its job as there was NOTHING left in the breast and only a few cells left in 2 nodes.

    Hang in there!  Wishing you the best! 

    Susie

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  • Kathleen26
    Kathleen26 Member Posts: 210
    edited February 2011

    Well this is interesting, because I had neo-adjuvant chemo, which only partially shrunk my original tumor and the mass I had in my axillary nodes.   Still had extensive extracapsulary extension upon surgery, when 8 positive nodes were found.   No one ever mentioned adjuvant therapy for me, but I did have 8 rounds neo-adjuvant (4 of AC and 4 of Taxol), and not your 4 total.

    If you only had 4 rounds during the first go-around, then it makes total sense to me that you should have the 'full chemo' experience, and get more. Did they say it would be the same chemo or something different?

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  • bonsi77
    bonsi77 Member Posts: 7
    edited February 2011

    Karina:

     My mom is going through something similar. She was Stage 2B/3A Triple Negative with 4.5cm tumor and 3 lymph nodes involved. She had neo-adjuvant chemo ACx4 and Taxol X4 dose dense. After her double mastectomy they found that some residual cancer was still left in the lymph nodes they removed. Since the neo-adjuvant chemo failed to give her a PCR (pathological complete response) she is now getting some additional chemo in the adjuvant setting. She is getting 4 cycles of gem/carb. Basically due to the fact that there was residual cancer left in her lymph nodes at the time of surgery that put her at a high risk for recurrence. So she is getting the adjuvant chemo now as precautionary measure in case there are any lingering cells in her body. Had the neo-adjuvant chemo killed everything off she wouldn't need additional chemo. 

    Was there any residual cancer left after you had neo-adjuvant chemo ? If so that is probably why your Onc is suggesting additional chemo.

    Hope this helps.

     Diane 

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  • Tg5471530
    Tg5471530 Member Posts: 111
    edited February 2011

    Dine-  My situation kind of sounds like your moms.  Stage 3b had a very large tumor, a smaller tumor dcis and 4 possitive nodes in the biginning which warrented me to have neo-adj ACTaxol 4x4 every 2 wks. then Bilat Mast with expanders.  Path showed that original 4.5 cm IDC shrank to 1, 1cm ILC was less than .02ml and DCIS was still there.  They decided to do rads to kill the rest of the cancer though.  I am praying they did it all.  I didnt respond well to tamoxofin and my hormones are back to normal, so I am haveng them, along with my gallbladder taken out on the 16th.  Im kid of scared that they may have waited too long though.  I actually think I feel a small lump under my right arm now which is the arm that only had pre-cancerous grouping found in the path, but no nodes taken out.  I'm only 36 with 3 young kids, and dont want to have to go through chemo again.

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  • NannaBaby
    NannaBaby Member Posts: 510
    edited February 2011

    I did 4AC and 4Taxotere before surgery, now I do rads, next is more chemo 4-6 Vinorelbine and Cisplatin.

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  • Karina121293
    Karina121293 Member Posts: 370
    edited February 2011

    Thanks for all your sharings. My tumour was 3.7mm initially after chemo it was about 2cm , so it shrunk ok, but my surgeon says it didn't respond too well to the chemo. Bonsi  I haven't heard about  residual cancer, and thanks , I will do some research and ask my onc about it. I hope with time I will get some peace of mind , so far I have been uneasy about the whole situation, esp the new way I look.... But it's inspiring to know that so many of you have got thru this with a victory.

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  • Gitane
    Gitane Member Posts: 1,885
    edited February 2011
    tammyg,  I am sorry you are having to deal with more surgery and hope that lump you feel is not BC.  It's so hard to get through all of this.  Giant hugs and strength being sent.  G.
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  • geewhiz
    geewhiz Member Posts: 1,439
    edited February 2011

    Kathleen26....how did you get staged at 3c with such a small tumor and 8 nodes? I seem to have similar stats and I got a 3a?

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  • Kathleen26
    Kathleen26 Member Posts: 210
    edited February 2011

    hi Geewhiz, in addition to the 8 axillary nodes, I also had positive nodes in the pectoral and subclavical areas, which is the reason for the IIIc.

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  • geewhiz
    geewhiz Member Posts: 1,439
    edited February 2011

    the way I look at it...THANK GOD for healthy lymph nodes doing their jobs of keeping it contained and from spreading :)

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  • bonsi77
    bonsi77 Member Posts: 7
    edited February 2011

    Karina:

     By residual cancer I meant how much of your tumor was left and/or was there cancer in your lymph nodes left after the chemo. So seeing as you said after chemo your tumor was still 2cm then you did have residual cancer left and that is why your Onc is recommending additional chemo. As much as it sucks to get more chemo when we talked about it with my Mom's Onc we felt like rather hit this thing with everything we got now and lower the chance of it coming back as we all know if it comes back it is a whole different ball game. So we figured do it now and hope that if there are any lingering cells that this 2nd blast will knock them out.

    Good luck and stay strong!

    Diane 

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  • Karina121293
    Karina121293 Member Posts: 370
    edited February 2011

    Diane,

    I am clear now on what it is!!!! Thank you, before your explanation I was thinking  residual cancer meant what is left after surgery and and freaked me out. So yes, by no means better to kick the beast out now without any chance of coming back!!!!!! Wish your mother quick recovery and all the best!

    Karina 

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