Can you ask for a different plan of action?

So I’m still in limbo as I still have to have a mri ct and bone scan to check my cancer is no where else. I am praying its not. 

However the Dr said we will be attacking my grade 3 cancer aggressively with chemo first. 

It’s playing on my mind terribly. I just want this cancer cut out, I can’t imagine having to leave it inside me for 5 months whilst I go through chemo. 

I know they say they want to not deform your boob and keep it as normal as possible. But I really don’t care about my boobs. Its the last thing on my mind. 

Can I say this? Is there any other reason to not do it this way?

Hi mrsquincey - I think it’s a very good idea for you to speak to your team to discuss the plan, they will be able to explain the thinking behind it. It is your body and there is nothing at all unreasonable about asking questions. Some people just go along with the plan and don’t want to know - others (like me) asked loads of questions, it is very personal.

I’m not medical so won’t try to explain their reasoning, except to say that chemo can be given first for a number of reasons. I was told in my case that it didn’t make any difference whether I had chemo or surgery first, and I did have chemo first. Sometimes they try to shrink the lump so that the person can have a lumpectomy rather than a mastectomy.

So in short - yes, you really can speak to your team, at any time, to discuss your plan. All the best to you - please feel free to ask any further questions. Evie xx

Just went back and saw your initial post Mrsquincey. I’m 38 with one toddler, so similar sort of situation, and only a couple of weeks ahead of you on this hellish “journey”. I also got told “apocrine features” tbh not sure what that means, let me know if you find out! It’s really rubbish, so unfair and frankly I’m *beep* off to have this diagnosis! But I am feeling more positive as time goes on. I have just been through all the scans etc and that is the hardest bit for sure. Be prepared for things having to be investigated that end up hopefully being nothing (I had an ovarian cyst, splenic cyst, swollen thymus and swollen chest nodes they were worried about at various stages all of which have turned out to be fine but it was utter hell waiting for each result). I do have lymph node involvement but my team don’t seem fazed by that so trying not to let it bother me either. I will be crossing my fingers for you for good news from the follow up tests and a swift start to treatment xx

Hi mrsquincy

I’m sorry you’re in this position where nothing seems to make sense. The blow of a cancer diagnosis and being in the presence of a consultant so knowledgeable initially tends to silence us. We soon learn!

I’m a bit confused by this thread as I didn’t see a mention of triple negative breast cancer, only grade 3, which we know is advanced. Hopefully your scans will show there has been no spread beyond the tumour or, at most, beyond the lymph nodes. I guess much depends on your age and your personal body image. I had my mastectomy and axillary clearance first (two stage 3 tumours, one of each type, and 19 of 21 lymph nodes infected BUT no spread beyond) because it was pre-Covid days. However, many hospitals have a different approach and prefer to shrink the tumour with chemo before surgery. Like you, I just wanted my breast gone but there’s no escaping the fear of cancer cells so, with hindsight and better understanding, I believe it doesn’t make a great difference which comes first. The risk and certainly the fears are still there regardless. The cancer is removed with surgery but there is no guarantee that some of the little b*****r aren’t still there so you still need chemo and, initially, the horror of the possibility of them spreading is still there.

I’d say it’s essential for you to have a proper conversation about the reasons for chemo before surgery before you agree and sign your treatment plan. Your consultant may wrongly (?) believe you want as much breast preserved as possible. But bear in mind there has been real progress in breast cancer treatment and there is strong evidence that the established pattern (mastectomy, then chemo) is not always best. What I would advise is that you don’t try to inform yourself via Google. It really is the worst thing you can do as it can’t take emotions into account, is often out of date and isn’t tailored to your specific circumstances.

Meanwhile, do all you can to focus on your emotional wellbeing, which is a huge part of the cancer experience. Keep yourself grounded, remember the success rates for breast cancer treatment are high and learn to trust your team to know what’s best for your specific circumstances. BUT always ask your questions. I wish you all the best for what lies ahead. It’s hard but it is all manageable and bearable - and nowhere near as frightening as you probably think it is right now. Best wishes, Jan x


im having chemo and feel the same its bloody awful


Im having chemo first im hers2 positive and er positve i didnt seem to have a choice just rushed to a chemo chair after diagnosis however the lump has shrunk from 3.7 cm to half an inch after two chemos its also in three nodes so hope it cleans it out before surgery. im really scared and can barely function convinced its been my wine consumption