Surgery after Neodjuvant Chemo shrinks LARGE tumor

Hi!

My lump was 5 cm+ and I had one compromised node. After AC+THP, an MRI and PET scan showed that there was no active cancer left in the breast or node. I opted for a lumpectomy, and the surgeon took a golf ball-sized amount of tissue out of my affected breast. The pathology report showed that the active cancer was gone, but that I'd had a tiny pocket of Grade 3 DCIS left over from chemo.

I was happy to have a lumpectomy because I did not want to do reconstruction. My right breast is a bit smaller than my left breast, and there is a scar where the tissue was removed. However, I do not feel deformed.

I did end up doing six weeks of radiation to my breast and nodal area. It was OK. My right breast did turn pink, and it felt like I had a sunburn. But, that cleared up a few weeks after completing radiation.

I should add that I was a C-cup to begin with, so I don't really miss that golf ball-sized amount of tissue. If I'd been an A or a B-cup, it might have been different.

Good luck!

Agatha,

Will your doctors order an MRI and/or PET scan after chemo is done? Those scans might give you an idea of how much is left (if anything) of the tumor. I noticed that you were Grade 3 (like me). Chemo often works very well for Grade 3 cancer; let's hope that's the case for you!

Thank you all for posting. It is reassuring to read your experiences. I'm just starting with chemo but the goal is to shrink the tumor and get rid of the lymph node involvement. Originally, I was a bit skeptical because everyone I had talked to (granted, a limited number of people) had surgery first and then additional treatments. After researching my options and further discussions with both the MO and BS, I decided to go the neoadjuvant route. Tomorrow is week #2 of 12 Taxol so thank your for the continued inspiration!

Mine was 5cm and I completed 5 months of Abraxane, Herceptin and Perjeta with the tumor shrinking to just a small cluster of cells. Starting with DD breasts, a lumpectomy was recommended with a lift and reduction on both to match (one OR, two surgeons). I ended up with D's and clear margins. I'm happy it was all handled at once, I wouldn't want multiple surgeries. Breast radiation followed, 30 sessions.

Agatha, yes, both nipples were saved, moved up a few inches and have their usual feeling/sensitivity. If the cancer is located directly under your nipple, saving it all may be more difficult but it worked out very well.

Hi AgathaNYC

This response might be a little late but I had a massive tumour... 8cm. After neoadjuvant chemo they couldn’t see it on MRI, mammogram or ultrasound. So I opted for a lumpectomy. Sadly there was still residual cells there. So I then had a mastectomy. And pathology showed there was a lot of residual cells. It was like Swiss cheese.All inactive, but still they were there and undetectable on screening. My lesson was that there can still be cancer that doesn’t show up on any screening.

My onc recommended a mastectomy. He said, “why wouldn’t you want all potential cells in the bin!” And so I did. They got clear margins, so that was my positive. Good luck.

Glad to help Agatha NYC. I also sought out a second opinion regarding surgery. I wanted to be sure that mastectomy and ALND was the right thing to do. In the end as it happens only my first level lymph nodes were involved but they took the lot. Now I’m living with the constant cloud of lymphodema and I have terrible and sometimes painful cording. But so far so good. Good luck. Xxxx