Lab Results before surgery? Normal for Neoadjuvant chemo?

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poisedandpink
poisedandpink Member Posts: 66
edited April 2019 in Surgery - Before, During, and After

I just finished my ACT chemo on March 8th. I'm scheduled to have surgery exactly a week from now. I went in for my pre-surgery testing yesterdat and received my lab results.

My Anion Gap was low 6 when normal range is 8-16

RBC slightly low 3.68 normal range 3.80-5.00

WBC low 2.8 normal range 4.00-11.00

Baso was slightly high 2.00 normal range 0.00-1.50

Everything else was normal.

I'm waiting to hear back from my surgeon if this will impact my surgery next week. I don't expect to hear back from him anytime soon as he's in operations all day today.

I was curious for anyone else who has had neoadjuvant chemo before surgery, if you experienced any range similar to this? I did not receive Nuelasta on my last treatment.

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  • hapa
    hapa Member Posts: 920
    edited March 2019

    My RBCs were in the toilet after chemo. My WBCs were really high all the way through due to the Neulasta. I did not get any bloodwork done before surgery after my last chemo so I have no idea what the numbers were but they were all over the map during chemo and nobody was concerned. I think you have to be off by orders of magnitude or be symptomatic before they start worrying. I breezed through surgery with no complications, went out for dinner two days after my BMX with implants. Best of luck!

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  • poisedandpink
    poisedandpink Member Posts: 66
    edited March 2019

    thanks! I’m still waiting to hear back from surgeon at MSK.I’m just hoping at this point no news is good news and if it was urgent they would have called to reschedule my surgery by now as it’s only six days away!

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  • Flynn
    Flynn Member Posts: 307
    edited March 2019

    I think as long as your neutrophil is not crazy low you’re be ok. I had low counts all thru chemo and went in to bmx with nothing in the normal category. My BS did arrange to have platelets available in case I needed them (I didn’t). Good luck to you

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  • kber
    kber Member Posts: 394
    edited April 2019

    If you don't mind sharing, what other tests did you do prior to surgery?  I'm about to (thankfully!) finish up neoadjuvant chemo and just scheduled my surgical consult.  I know my tumor has shrunk significantly during chemo and was wondering what other tests might be standard / warranted? MRI? PET?  


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  • poisedandpink
    poisedandpink Member Posts: 66
    edited April 2019

    Hi kber,

    I had to do an MRI and Mammogram. I then met with my surgeon to discuss surgery options after he reviewed those results. Chemo did shrink the tumor (the surgeon could see it on the scans but could no longer feel it) I had skin thickening that was also reduced and no unusual lymph nodes.

    Once surgery was was decided (I'm doing a bilateral mastectomy with potential nipple sparing that decision will be made in surgery), I had to do bloodwork and an ekg. I also had to meet with my plastic surgeon to discuss reconstruction. At that appointment, pictures were taken for my before. I'm going to be doing tissue expanders with implants put in at a later surgery.

    My bloodwork results of wbc 2.8 were actually too low for surgery. However, I was retested yesterday and my wbc was up to 3.6 so surgery is officially on for Thursday! Tomorrow I have a pre-surgery appointment to do mapping of my lymph nodes. I previously had a lymph node biopsy that came back negative pre-chemo, everything looks normal on my scans but they will still remove sentinel lymph nodes to test just to be sure.

    Hope that helps!

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  • kber
    kber Member Posts: 394
    edited April 2019

    Thanks for the info and best of luck Thursday!  

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  • WC3
    WC3 Member Posts: 1,540
    edited April 2019

    poisedandpink:

    I don't recall what my anion gap was but they seemed primarily concerned with my platelets, RBC and hemocrit.

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  • poisedandpink
    poisedandpink Member Posts: 66
    edited April 2019

    yeah, they didn’t even retest my anion gap. My surgeon thought everything was an okay range except my wbc 2.8 was too low for surgery. They retested me 5 days later and I was up to 3.6 so surgery is tomorrow!

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  • WC3
    WC3 Member Posts: 1,540
    edited April 2019

    Good luck!

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