surgery then chemo with large tumor

I had surgery first followed by radiation. No chemo, as my Oncotype score was 18. I was never given the option of doing anything but getting right to surgery. My tumor was over 6cm and very close to the chest wall.I have been on Tamoxifen since Jan 1.

I also had clear mammos and ultrasounds right before my multicentric tumor (in all 4 quadrants) was removed. And, yes, it did seem to come out of nowhere.

There are so many treatment variations that you can make yourself crazy wondering if you are doing the right thing. If you trust your team, best to trust the treatment.

Beth--Perhaps since you are in Canada, the standards of care are different. Here in the U.S., I was told that there is no evidence and they have not been able to prove that chemo first is better than surgery first. It is only an assumption. However, they believe they can monitor the progress of chemo on the tumor during neoadjuvant, so that seemed like a good idea to me. So I guess it's not really standard of care here perhaps, but it's done. I had it at a major cancer research center, supported by an even more major center's second opinion.

Hi Beth, I'm also from Ontario and I was dx in May, although all my tests, including needle biopsy were negative. I felt large lump and insisted on removing it. Dr did lumpectomy but left a lot of cancer behind! So I ended up having another surgery in Toronto to remove breast on Jun 27th along with bowel resection as I found early stage another primary cancer in my colon. This time everything was removed with lots of nodes affected by BC. Colon is fine, doesn't need any treatment.

I just started dose dense chemo on Aug 1st. (AC x 4 and the Paclitaxol x4). So far doing great! Recovery from 7.5 hr surgery went very well, I was happy to start only 4 weeks after. Once this is over I'm having prophylactic mastectomy possibly with reconstruction. With ILB risk of recurrence increases with each year by 1% if breasts are left... this is what my onc told me. So I guess it is fine to have surgery first especially if tumor is well isolated and fully operable. The only thing is that with no cancer left behind we don't know if chemo works well on those invisible cancer cells that could have escaped ... Although using chemo drugs that have a good success history there is no reason to believe otherwise.

Good luck! Please, msg me if you have any questions.

I had chemo (Taxatere & Cytoxan) first, mastectomy, then 30 radiation treatments with severe burns/blisters. Last radiation treatment the last of March. During surgery on January 12th, they were able to remove 98% of the cancer but could not get clear margins. My tumor was against my chest wall and had already invaded the muscle. Was your surgery successful in getting clear margins? I started Armidex in April but after a month, was changed to Tamoxifen. For me, the sides effects are the same with both drugs. The hot flashes have become unbearable at times becoming more like body sweats 24/7 and I end up wet from head to toe, can't sleep without medication to help me sleep. They tell me how important it is for me to take this but I don't know if I will. Right now, I would love to feel halfway - normal whatever that is. The aches/pains in the joints and muscles aren't getting any better and about a month ago, they gave me a pain patch to help with the SE of Tamoxifen...just can't win. The other day I got down in the floor to get something under the bed and I could not physically get up. I am far from being young but this has never happened to me before...my legs have always been strong. I am trying to be positive but each day, with these horrible symptoms, it's so hard...

I had a lumpectomy last week for what we thought was small but was found to be a 6.7 cm or larger mixed ILC and IDC. Mastectomy to follow, but Drs said neo- adjunct chemo to shrink pre surgery in my case would have been to have a better cosmetic outcome only. So I feel it should have been done if only they knew but they say doesn't matter. I just wish they had done an MRI first so it could have all been removed the 1st surgery.   

I had bmx first , MRI was unclear about size, it read at least 3cm, thats the part that got to me the most, the "at least", as it turned out it was 5.8 cm, no nodes involved, then chemo and rads.  I believe chemo was after surgery because they weren't quite sure how big it really was.