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pingpong1953
pingpong1953 Member Posts: 362
edited May 2017 in Diagnosed and Waiting for Test Results

I was diagnosed with IDC in April, had lumpectomy and sentinal node biopsy that showed one positive node. I forgot to ask how large the lump was, which I realize is an important part of staging, but based on what I've been able to figure I'm pretty sure I'll need chemo as well as radiation. My question is, do they always do chemo first, or do they sometimes start with radiation?

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  • LisaAlissa
    LisaAlissa Member Posts: 1,092
    edited May 2017

    Hi pingpong!

    What do your docs advise? If you haven't seen a MO and a RO, then now's the time! If they agree about which is first, then you have your answer. If they don't, then ask them to take your case to a tumor board.

    BTW (for others), under some circumstances, chemo is before surgery! (called neoadjuvent chemotherapy).

    My very best wishes for easy and effective treatments!

    LisaAlissa

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  • Kicks
    Kicks Member Posts: 4,131
    edited May 2017

    Neoadjuvant (pre-surgery) is the SOP (standard) for IBC and has been for years. It is becoming more common for other types of BC. Adjuvant (post surgery) Chemo has been used for MANY years for most other types of BC and is the most common type of Chemo done.

    Neoadjuvant Chemo is used to get the mass to form into a 'lump' (IBC forms as 'nest' or in 'bands' - not a 'lump'), shrink it , get good margins for less invasive surgery.

    As you've already had SX, any Chemo you do will be adjuvant (post surgery). Rads will follow after end of Chemo if done.

    (A few of us do both neoadjuvant and adjuvant Chemo. Both before rads.)

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  • pingpong1953
    pingpong1953 Member Posts: 362
    edited May 2017

    I've been referred to an MO and a RO but I don't have appointments yet. I'll have a scan on June 5, so there's probably no point in seeing either one of them before the results are back from the scan.

    I live in a small city in northern Ontario and will be seeing specialists in a regional cancer centre in a city about 2 hours east of where I live. I was able to have the surgery at the hospital here in town, and once I have a chemo routine I'll be able to get it here, also, but I have to travel to the regional centre for radiation. Fortunately they have a place similar to a Ronald McDonald house at the hospital where I can stay during the week for treatment.

    Right now I'm trying to get a dental problem cleared up before I can start any sort of treatment!

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  • gb2115
    gb2115 Member Posts: 1,894
    edited May 2017

    Chemo before radiation. There is always a chance you might not need chemo, if your tumor wasn't huge. I had a positive node and because of genomic testing results, I was spared from chemo.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited May 2017

    I've got almost the same dx May15 with .. IDC 1.7 tumor .. Clinical stage 2 A ..grade 3 /High ....HR/PR pos. and HER2 pos. one known lymph node involved..
    Get my MRI on Thursday then see the Oncologist and Surgeon on Friday ..
    Was wondering if they would do Chemo first.. then surgery .. then maybe radiation .. then the therapy for HR and HER2 next..
    So overwhelmed...

    Denise in TN

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited May 2017

    DeniseT,

    BC patients who are HER2+ often do chemo before surgery. That is because national guidelines recommend Perjeta for HER2+ cancers that are over 2 cm in size. Your tumor (1.7 cm) is a bit smaller than 2 cm, but you might want to ask about Perjeta as well. (Perjeta, like Herceptin, is a targeted therapy for HER2+ cancers.) Take a deep breath! And, be sure to jot down your questions in a notebook before your appointments with your oncologist and surgeon.

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  • pingpong1953
    pingpong1953 Member Posts: 362
    edited May 2017

    Well, the whole "chemo first or radiation first?" question is moot - since I have a history of lupus, the RO told me I'd be a bad candidate for radiation. He's going to take it to the tumour board, but I'm thinking I should heed his warning and get a mastectomy and removal of the remaining lymph nodes. I was a bit upset at first, but I've made my peace with this. The RO is going to refer me to a BS and a PS (should I decide on reconstruction, which I probably will.) Now my next hurdle is a bone scan on Monday. Keeping my fingers crossed!

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